ADVANCED SOUTHERN SURGICAL NPI 1699823450

NPI Information

  • NPI: 1699823450
  • Provider Name: ADVANCED SOUTHERN SURGICAL
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 604 N ACADIA RD
    SUITE 406
    THIBODAUX, LA
    ZIP 70301
  • Phone: (985) 446-2524

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NPI Details

ADVANCED SOUTHERN SURGICAL is a specialist in Thibodaux, LA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ADVANCED SOUTHERN SURGICAL NPI is 1699823450. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

604 N ACADIA RD
SUITE 406
THIBODAUX, LA
ZIP 70301-847
Phone: (985) 446-2524
Fax: (985) 447-2329

The provider's authorized official is Johnny Perez .
The authorized official title is Manager and has the following contact phone number (985) 446-2524.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 5/25/2011.

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
1174400000XSpecialist15745RLOUISIANAYes

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
15CM48MEDICARE PINLOUISIANA

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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