Healthcare Provider Details

I. General information

NPI: 1861663098
Provider Name (Legal Business Name): ASCENT SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2008
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 CORPORATE DR
COLORADO SPRINGS CO
80919-1941
US

IV. Provider business mailing address

5901 CORPORATE DR
COLORADO SPRINGS CO
80919-1941
US

V. Phone/Fax

Practice location:
  • Phone: 719-598-7192
  • Fax: 719-634-2686
Mailing address:
  • Phone: 719-598-7192
  • Fax: 719-634-2686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREGORY JOHN LIEBSCHER
Title or Position: MEMBER
Credential: M.D.
Phone: 719-598-7192