Loris Surgical Associates, PA

NPI #1902947609 in Loris, South Carolina

Provider Information

NPI Number: 1902947609
Entity Type: Organization
Organization Name: Loris Surgical Associates, PA
Primary Specialty: Surgery
Enumeration Date: Feb 8, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 3327 CASEY ST
City: Loris
State: South Carolina
ZIP Code: 29569-2811
Phone: (843) 756-5524

Authorized Official

Name: DR. LANE INGRAM MOORE, MD
Title: PRESIDENT
Phone: (843) 756-5524

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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