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General NPI Number Information
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NPI Number | 1538787361
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Entity Type | Organization
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Legal Business Name | EYE SURGERY CENTER OF MORRISTOWN, LLC
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 1639 W MORRIS BLVD
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City | MORRISTOWN
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State | TN
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Zip | 37813-2832
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Country | US
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Telephone | 423-690-2600
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Fax | 423-690-2601
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Provider Business Mailing Address
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Address Line | 448 N. CEDAR BLUFF RD STE 255
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City | KNOXVILLE
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State | TN
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Zip | 37923-3612
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Country | US
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Telephone | 423-690-2600
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Fax | 423-690-2601
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER/EXEC DIR.
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Name | MR. STEPHEN H RUDOLPH SR.
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Credential | CPA
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Telephone | 423-690-2600
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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 |
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License Number State |
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