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General NPI Number Information
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NPI Number | 1336665306
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Entity Type | Organization
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Legal Business Name | EAGAN ORTHOPEDIC SURGERY CENTER LLC
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 2700 VIKINGS CIR STE 300
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City | EAGAN
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State | MN
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Zip | 55121-1002
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Country | US
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Telephone | 952-456-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 AMERICAN BLVD W STE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4442
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHRIS ZEIGLER
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Credential |
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Telephone | 952-456-7436
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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 |
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License Number State |
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