Healthcare Provider Details

I. General information

NPI: 1033105960
Provider Name (Legal Business Name): SURGERY CENTER OF OAK RIDGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 OAK RIDGE TPKE SUITE 200
OAK RIDGE TN
37830-6959
US

IV. Provider business mailing address

944 OAK RIDGE TPKE SUITE 200
OAK RIDGE TN
37830-6959
US

V. Phone/Fax

Practice location:
  • Phone: 865-835-5000
  • Fax: 865-835-5005
Mailing address:
  • Phone: 865-865-5001
  • Fax: 865-865-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number0000000125
License Number StateTN

VIII. Authorized Official

Name: MRS. SONYA SWINT
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 865-865-5014