Healthcare Provider Details

I. General information

NPI: 1215187802
Provider Name (Legal Business Name): FISHERS AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13914 STATE ROAD 238 EAST SUITE 200
FISHERS IN
46037-5506
US

IV. Provider business mailing address

13914 STATE ROAD 238 EAST SUITE 200
FISHERS IN
46037-7211
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-9180
  • Fax: 317-415-9068
Mailing address:
  • Phone: 317-415-9180
  • Fax: 317-415-9068

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: DR. ANDREW T. TROBRIDGE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 765-741-2957