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General NPI Number Information
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NPI Number | 1346349164
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Entity Type | Organization
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Legal Business Name | SOUTHERN ALABAMA SURGERY CENTER LLC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 2800 ROSS CLARK CIR SUITE 3
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City | DOTHAN
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State | AL
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Zip | 36301-2040
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Country | US
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Telephone | 334-793-3411
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Fax | 334-712-0227
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Provider Business Mailing Address
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Address Line | 2800 ROSS CLARK CIRCLE SUITE 3
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City | DOTHAN
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State | AL
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Zip | 36301
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Country | US
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Telephone | 334-793-3411
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Fax | 334-712-0227
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Authorized Official
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Title or Position | ADMINISTER
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Name | MRS. SHARRON ALANE BYRD
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Credential |
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Telephone | 334-793-3411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 12124
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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