Surgical Associates PC Crna

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

22789 Issued in IA

Legal business name

SURGICAL ASSOCIATES PC CRNA

Practice address

801 13TH St
Charles City, IA 50616-3443

Phone

(641) 228-1143

Fax

(641) 228-7621

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Sawat Phruttitum, M.D.

Title

Owner

Phone

(641) 228-1143

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508907890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 13TH ST",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163443",
            "telephone_number": "641-228-1143",
            "fax_number": "641-228-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 13TH ST",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163443",
            "telephone_number": "641-228-1143",
            "fax_number": "641-228-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES PC CRNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHRUTTITUM",
        "authorized_official_first_name": "SAWAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-228-1143",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "IA",
            "license": "22789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0127647",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Charles City, IA
• Providers in Charles City, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.