| Organization Name: | BRUNSWICK SURGICAL ASSOCIATES, PLLC |
| NPI Number: | 1144206822 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK TILLOTSON (PARTNER) |
| Mailing Address: | 6 Doctors Cir Suite 1 Supply |
| State: | NC US |
| Postal Code: | 284624089 |
| Phone Number: | 9105754606 |
| Fax Number: | 9105754609 |
| NPI Enumeration Date: | 12/15/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | 103114 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |