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General NPI Number Information
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NPI Number | 1477546687
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR OUTPATIENT SURGERY, LLC
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 402 KEENE ST SUITE 200
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City | COLUMBIA
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State | MO
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Zip | 65201-6626
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Country | US
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Telephone | 573-499-1150
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Fax | 573-443-4669
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Provider Business Mailing Address
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Address Line | 402 KEENE ST SUITE 200
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City | COLUMBIA
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State | MO
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Zip | 65201-6626
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Country | US
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Telephone | 573-499-1150
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Fax | 573-443-4669
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LOWELL SCHOENGARTH
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Credential | M.D.
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Telephone | 573-499-1150
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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 | 116-2
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License Number State | MO
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