Healthcare Provider Details

I. General information

NPI: 1477853901
Provider Name (Legal Business Name): ANDERSON SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7691 5 MILE RD SUITE 10 B
CINCINNATI OH
45230-4348
US

IV. Provider business mailing address

7691 5 MILE RD SUITE 10 B
CINCINNATI OH
45230-4348
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-7246
  • Fax: 937-624-6900
Mailing address:
  • Phone: 513-624-7246
  • Fax: 937-624-6900

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: MUKARRAM A KHAN
Title or Position: OWNER
Credential: D.O.
Phone: 513-624-7246