Healthcare Provider Details

I. General information

NPI: 1427641042
Provider Name (Legal Business Name): ALLISONVILLE OUTPATIENT SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2021
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10967 ALLISONVILLE ROAD
FISHERS IN
46038-2632
US

IV. Provider business mailing address

10967 ALLISONVILLE RD STE 100
FISHERS IN
46038-2634
US

V. Phone/Fax

Practice location:
  • Phone: 317-569-0033
  • Fax: 317-569-0540
Mailing address:
  • Phone: 317-569-0033
  • Fax: 317-569-0540

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: MRS. RACHELLE LYNN KILLION
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 317-569-0033