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General NPI Number Information
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NPI Number | 1396719563
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Entity Type | Organization
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Legal Business Name | BAPTIST GERMANTOWN SURGERY CENTER, LLC
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 2100 EXETER RD SUITE 101
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City | GERMANTOWN
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State | TN
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Zip | 38138-3922
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Country | US
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Telephone | 901-757-3400
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Fax | 901-751-2870
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Provider Business Mailing Address
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Address Line | 2100 EXETER RD SUITE 101
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City | GERMANTOWN
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State | TN
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Zip | 38138-3922
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Country | US
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Telephone | 901-757-3400
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Fax | 901-751-2870
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Authorized Official
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Title or Position | SR VP/CLO
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Name | GREGORY M DUCKETT
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Credential |
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Telephone | 901-227-5233
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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 | 0000000067
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License Number State | TN
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