Surgeon'S Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18107 Issued in WV

Legal business name

SURGEON'S INC

Practice address

4000 Johnson Rd FL 2
Steubenville, OH 43952-2364

Phone

(740) 266-5959

Fax

(740) 266-5957

NPI assigned

Jul 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Samuel D Licata, MD

Title

Owner

Phone

(740) 266-3595

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1083639009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 JOHNSON RD FL 2",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522364",
            "telephone_number": "740-266-5959",
            "fax_number": "740-266-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 JOHNSON RD FL 2",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522364",
            "telephone_number": "740-266-5959",
            "fax_number": "740-266-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGEON'S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "LICATA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-266-3595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WV",
            "license": "18107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00013780000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0416964",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorie Sullivan
• Vanita Lakshmi Sundararaman, PHARM-D, BCPS, BCADM
• Francis Sunseri, M.D.
• Cora Elizabeth Suppa, CCMA
• Maryalice D Surgenavic
• Victoria R. Sutphin, PA
• Milton Eduardo Swaby, M.D.
• Michele A Swan, CFNP
• Timothy P Sweeney
• Amy Switzer

• Surgery Physician in Steubenville, OH
• Providers in Steubenville, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.