=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568383495
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORTHO SURG AMBULATORY SURGERY CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2026
-----------------------------------------------------
Last Update Date | 07/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 CIRCLE FRONT DR
-----------------------------------------------------
City | EVANSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47715-7196
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-483-6872
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 225 CROSSLAKE DR
-----------------------------------------------------
City | EVANSVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47715-8198
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-488-4639
-----------------------------------------------------
Fax | 812-488-4639
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | ZACH ZIRKELBACH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 812-483-6872
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------