Healthcare Provider Details

I. General information

NPI: 1124125331
Provider Name (Legal Business Name): AMBULATORY SURGERY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 CAPITAL AVE SW SUITE 101
BATTLE CREEK MI
49015-9393
US

IV. Provider business mailing address

3600 CAPITAL AVE SW SUITE 101
BATTLE CREEK MI
49015-9393
US

V. Phone/Fax

Practice location:
  • Phone: 269-979-2490
  • Fax: 269-979-2690
Mailing address:
  • Phone: 269-979-2490
  • Fax: 269-979-2690

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: JOSEPH E BURKHARDT
Title or Position: BOARD MEMBER
Credential:
Phone: 269-979-2490