Indiana Specialty Surgery Center, Llc

NPI 1174777817 - Clinic/Center - 261QA1903X

NPI Details
NPI 1174777817
Enumeration Date 11/07/2008
Last Updated 11/07/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name GREGORY M GREGORY
Position CEO
Phone (812) 330-1164
Fax (812) 332-5102
Practice Location
1380 W ARCH HAVEN AVE
BLOOMINGTON IN, 47403-2055, US
Phone (812) 330-1164
Fax (812) 332-5102
Business Location
1380 W ARCH HAVEN AVE
BLOOMINGTON IN, 47403-2055, US
Phone (812) 330-1164
Fax (812) 332-5102
Toxanomy
Taxonomy Code 261QA1903X
License State
License Number
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According to our database, Indiana Specialty Surgery Center, Llc NPI is 1174777817, taxonomy code is 261QA1903X Indiana Specialty Surgery Center, Llc physically located at 1380 W Arch Haven Ave, Bloomington IN, 47403-2055. NPI Number 1033115704 has the healthcare provider type.

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1174777817 NPI number is provided on an as is basis without warranty of any kind. 1174777817 is maintained by the National Plan & Provider Enumeration System. The contents of Indiana Specialty Surgery Center, Llc are for informational purposes only.