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General NPI Number Information
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NPI Number | 1497791503
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Entity Type | Organization
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Legal Business Name | OHIO VALLEY SURGERY CENTER LLC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 4461 STATE ROUTE 159 STE A
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-8620
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Country | US
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Telephone | 740-774-9923
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Fax | 740-774-9921
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Provider Business Mailing Address
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Address Line | 4461 STATE ROUTE 159 STE A
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-8620
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Country | US
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Telephone | 740-774-9923
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Fax | 740-774-9921
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Authorized Official
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Title or Position | GOVERNING BODY
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Name | C MITCHELL FIELDS
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Credential | M.D.
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Telephone | 740-774-9923
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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 | 0569AS
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License Number State | OH
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