Healthcare Provider Details

I. General information

NPI: 1497750426
Provider Name (Legal Business Name): NEW ALBANY OUTPATIENT SURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 GREEN VALLEY RD
NEW ALBANY IN
47150-4647
US

IV. Provider business mailing address

2831 LONE OAK RD
PADUCAH KY
42003-8041
US

V. Phone/Fax

Practice location:
  • Phone: 812-949-1223
  • Fax: 812-945-4765
Mailing address:
  • Phone: 270-554-8373
  • Fax: 270-554-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number022237
License Number StateIN

VIII. Authorized Official

Name: MELISSA WILLIAMS
Title or Position: OFFICER AND AUTHORIZED OFFICIAL
Credential:
Phone: 270-554-8373