Provider Demographics
NPI:1447018189
Name:REFINED SURGICAL ASSISTING, LLLP
Entity type:Organization
Organization Name:REFINED SURGICAL ASSISTING, LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:541-525-2829
Mailing Address - Street 1:1182 OLD PENDERGRASS RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-2763
Mailing Address - Country:US
Mailing Address - Phone:541-525-2829
Mailing Address - Fax:
Practice Address - Street 1:1182 OLD PENDERGRASS RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-2763
Practice Address - Country:US
Practice Address - Phone:541-525-2829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REFINED SURGICAL ASSISTING, LLLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty