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NPI Code Detail

MEDICARE: NOVAMED EYE SURGERY CENTER (PLAZA), LLC

MEDICARE: NOVAMED EYE SURGERY CENTER (PLAZA), LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center79-8MO

General Provider Information

NPI Number : 1851397434
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVAMED EYE SURGERY CENTER (PLAZA), LLC
Provider Business Mailing Address
First Line : 1700 E HIGGINS RD
Second Line : STE 240
City : DES PLAINES
State : IL
Zip : 60018-3888
Country : US
Telephone Number : 847-296-5700
Fax Number : 847-296-5990
Provider Business Practice Location Address
First Line : 4321 WASHINGTON ST
Second Line : STE 6000
City : KANSAS CITY
State : MO
Zip : 64111-5933
Country : US
Telephone Number : 816-753-6511
Fax Number : 816-227-4099
Authorized Official
Title or Position : EVP OF THE MANAGER
Name : MR. SCOTT MACOMBER
Credential :
Telephone Number : 312-664-4100
Provider Enumeration Date : 06/28/2005
Last Update Date : 08/22/2020

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Directions to “NOVAMED EYE SURGERY CENTER (PLAZA), LLC ” Practice Location

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