BRUNSWICK SURGICAL ASSOCIATES PLLC NPI 1144206822

NPI Information

  • NPI: 1144206822
  • Provider Name: BRUNSWICK SURGICAL ASSOCIATES, PLLC
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • Address: 6 DOCTORS CIR
    SUITE 1
    SUPPLY, NC
    ZIP 28462
  • Phone: (910) 575-4606

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NPI Details

BRUNSWICK SURGICAL ASSOCIATES, PLLC is a vascular surgery surgery in Supply, NC. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. BRUNSWICK SURGICAL ASSOCIATES, PLLC NPI is 1144206822. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6 DOCTORS CIR
SUITE 1
SUPPLY, NC
ZIP 28462-089
Phone: (910) 575-4606
Fax: (910) 575-4609

The provider's authorized official is Mark Tillotson .
The authorized official title is Partner and has the following contact phone number (910) 575-4606.

The enumeration date for this NPI number is 12/15/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular Surgery103114NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
189015K7MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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