Healthcare Provider Details

I. General information

NPI: 1992882153
Provider Name (Legal Business Name): KNIGHTSBRIDGE SURGERY CENTER, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 KNIGHTSBRIDGE BLVD SUITE 110
COLUMBUS OH
43214-2463
US

IV. Provider business mailing address

4845 KNIGHTSBRIDGE BLVD SUITE 110
COLUMBUS OH
43214-2463
US

V. Phone/Fax

Practice location:
  • Phone: 614-273-0400
  • Fax: 614-273-0401
Mailing address:
  • Phone: 614-273-0400
  • Fax: 614-273-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0654AS
License Number StateOH

VIII. Authorized Official

Name: DR. PHILIP H TAYLOR
Title or Position: CHAIRMAN OF THE BOARD
Credential: M.D.
Phone: 614-273-0400