Healthcare Provider Details

I. General information

NPI: 1720157860
Provider Name (Legal Business Name): SURGERY CENTER PLUS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7430 N SHADELAND AVE SUITE 100
INDIANAPOLIS IN
46250-2036
US

IV. Provider business mailing address

7430 N SHADELAND AVE SUITE 100
INDIANAPOLIS IN
46250-2070
US

V. Phone/Fax

Practice location:
  • Phone: 317-841-8005
  • Fax: 317-577-7538
Mailing address:
  • Phone: 317-841-8005
  • Fax: 317-577-7538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: CINDY L DUNN
Title or Position: ADMINISTRATOR
Credential:
Phone: 317-841-8005