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General NPI Number Information
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NPI Number | 1356307565
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Entity Type | Organization
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Legal Business Name | AMBULATORY SURGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 725 KINGS LN
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City | TULLAHOMA
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State | TN
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Zip | 37388-5372
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Country | US
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Telephone | 931-455-1976
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Fax | 931-455-7122
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Provider Business Mailing Address
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Address Line | 725 KINGS LN
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City | TULLAHOMA
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State | TN
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Zip | 37388-5372
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Country | US
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Telephone | 931-455-1976
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Fax | 931-455-7122
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KRISTEN OCONNOR
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Credential |
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Telephone | 615-376-7315
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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 | 0000000148
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License Number State | TN
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