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General NPI Number Information
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NPI Number | 1104055425
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Entity Type | Organization
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Legal Business Name | WARTBURG SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1236 KNOXVILLE HWY
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City | WARTBURG
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State | TN
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Zip | 37887-4200
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Country | US
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Telephone | 423-346-2015
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Fax | 423-346-7541
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | WARTBURG
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State | TN
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Zip | 37887-0388
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Country | US
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Telephone | 423-346-2015
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Fax | 423-346-7541
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. TIMOTHY S OCHS
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Credential | CRNA
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Telephone | 423-346-2015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0000000133
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License Number State | TN
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