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General NPI Number Information
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NPI Number | 1487693123
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Entity Type | Organization
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Legal Business Name | CLARKSVILLE SURGERY CENTER LLC
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 793 WEATHERLY DR
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City | CLARKSVILLE
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State | TN
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Zip | 37043-8942
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Country | US
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Telephone | 931-542-2915
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Fax | 931-648-1816
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Provider Business Mailing Address
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Address Line | 793 WEATHERLY DR
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City | CLARKSVILLE
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State | TN
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Zip | 37043-8942
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Country | US
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Telephone | 931-542-2915
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Fax | 931-648-1816
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SCOTT MONTGOMERY
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Credential |
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Telephone | 931-645-1373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 0000000095
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0000000095
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License Number State | TN
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