Healthcare Provider Details

I. General information

NPI: 1184948663
Provider Name (Legal Business Name): ASSOCIATED UROLOGISTS AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 05/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVE STE G SUITE 100
MANHATTAN KS
66502-2709
US

IV. Provider business mailing address

1133 COLLEGE AVE STE G SUITE 100
MANHATTAN KS
66502-2709
US

V. Phone/Fax

Practice location:
  • Phone: 785-537-0304
  • Fax: 785-539-4710
Mailing address:
  • Phone: 785-537-0304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. APOSTOLOS EVANGELIDIS
Title or Position: CEO
Credential: MD
Phone: 785-537-0304