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General NPI Number Information
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NPI Number | 1477551745
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Entity Type | Organization
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Legal Business Name | GP SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 5404 SOUTHWEST LEE BOULEVARD SUITE 100
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City | LAWTON
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State | OK
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Zip | 73505-9521
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Country | US
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Telephone | 580-536-7533
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Fax | 580-536-7535
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Provider Business Mailing Address
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Address Line | 5404 SOUTHWEST LEE BOULEVARD SUITE 100
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City | LAWTON
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State | OK
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Zip | 73505-9521
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Country | US
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Telephone | 580-536-7533
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Fax | 580-536-7535
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KATHERINE L. REED
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Credential |
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Telephone | 972-763-3859
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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 | 0027
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License Number State | OK
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