Healthcare Provider Details

I. General information

NPI: 1568383495
Provider Name (Legal Business Name): ORTHO SURG AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CIRCLE FRONT DR
EVANSVILLE IN
47715-7196
US

IV. Provider business mailing address

225 CROSSLAKE DR
EVANSVILLE IN
47715-8198
US

V. Phone/Fax

Practice location:
  • Phone: 812-483-6872
  • Fax:
Mailing address:
  • Phone: 812-488-4639
  • Fax: 812-488-2264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAUL E. PERRY
Title or Position: MD
Credential:
Phone: 812-477-1558