Healthcare Provider Details
I. General information
NPI: 1285664300
Provider Name (Legal Business Name): PHYSICIANS OUTPATIENT SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2006
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1933 WASHINGTON BLVD
BELPRE OH
45714-2041
US
IV. Provider business mailing address
418 GRAND PARK DR SUITE 315
PARKERSBURG WV
26105-4000
US
V. Phone/Fax
- Phone: 740-423-7557
- Fax: 740-423-7559
- Phone: 304-428-3500
- Fax: 304-422-7900
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
SPENCER
GEORGE
Title or Position: PARTNER/MEDICAL DIRECTOR
Credential: MD
Phone: 304-428-3500