Provider Demographics
NPI:1659254969
Name:PRECISION SURGICAL ASSIST, LLC
Entity type:Organization
Organization Name:PRECISION SURGICAL ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUES EMILE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSSIERE
Authorized Official - Suffix:
Authorized Official - Credentials:LSA/CSA
Authorized Official - Phone:301-257-6191
Mailing Address - Street 1:2453 KENBROOK CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-3227
Mailing Address - Country:US
Mailing Address - Phone:301-257-6191
Mailing Address - Fax:
Practice Address - Street 1:8401 MAYLAND DR STE S
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4648
Practice Address - Country:US
Practice Address - Phone:301-257-6191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-26
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty