Healthcare Provider Details

I. General information

NPI: 1295713568
Provider Name (Legal Business Name): HUTCHINSON AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 N WALDRON ST
HUTCHINSON KS
67502-1143
US

IV. Provider business mailing address

2205 N WALDRON ST
HUTCHINSON KS
67502-1143
US

V. Phone/Fax

Practice location:
  • Phone: 620-728-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberS-078-003
License Number StateKS

VIII. Authorized Official

Name: ROBERT DAVIDSON
Title or Position: COO
Credential:
Phone: 620-669-2500