SURGICAL WEIGHT LOSS CLINIC PLLC


Address: 3716 Pacific Ave, Suite B, Tacoma, WA 98418-7836
Phone: 2534729850

SURGICAL WEIGHT LOSS CLINIC PLLC (NPI# 1811015399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811015399
Entity Type Organization
Organization Name SURGICAL WEIGHT LOSS CLINIC PLLC
Practice Address 3716 Pacific Ave
Suite B
Tacoma
WA 98418-7836
Practice Telephone 2534729850
Mailing Telephone 2534729850
Enumeration Date 2007-03-26
Last Update Date 2020-08-22
Authorized Official Name DR. SAMUEL ROSS FOX (OWNER & SURGEON)
Authorized Official Telephone 2534729850
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM2500X Clinic/Center
Specialization: Medical Specialty
MD0002094 WA Ambulatory Health Care Facilities
N 261QM2500X Clinic/Center
Specialization: Medical Specialty
MD00005293 WA Ambulatory Health Care Facilities
Y 261QM2500X Clinic/Center
Specialization: Medical Specialty
========= WA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WA NPI FOR SAMUEL ROSS FOX 1942363353 01
WA 7124175 05
WA DSHS FOR SAMUEL ROSS FOX 8178618 01
WA NPI FOR EARL ROSS FOX 1306919725 01
WA DSHS FOR EARL ROSS FOX 1016468 01

Office Location

Street Address 3716 PACIFIC AVE
SUITE B
City TACOMA
State WA
Zip Code 98418-7836

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1780604009 Living & Wellness Centers Ps Physical Medicine & Rehabilitation 3716 Pacific Ave, #e, Tacoma, WA 98418 2006-07-20
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1558409441 Fernando Francisco Deguzman Family Medicine 3716 Pacific Ave, Suite D, Tacoma, WA 98418-7836 2007-02-02
1831267251 Paul Alexander Massage Therapist 3716 Pacific Ave, Ste E, Tacoma, WA 98418-7836 2006-12-01
1306919725 Earl Ross Fox Surgery 3716 Pacific Ave, Suite B, Tacoma, WA 98418 2006-11-15
1295812501 Scott Leslie Havsy Physical Medicine & Rehabilitation 3716 Pacific Ave, Suite E, Tacoma, WA 98418-7836 2006-11-01
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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 261QM2500X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Medical Specialty

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

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Competitor

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City TACOMA
Zip Code 98418

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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