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General NPI Number Information
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NPI Number | 1588607154
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF INDIANAPOLIS LLC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12188 N MERIDIAN ST 150
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City | CARMEL
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State | IN
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Zip | 46032-4578
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Country | US
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Telephone | 317-569-8250
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Fax | 317-569-8363
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Provider Business Mailing Address
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Address Line | 12188 N MERIDIAN ST 150
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City | CARMEL
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State | IN
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Zip | 46032-4578
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Country | US
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Telephone | 317-569-8250
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Fax | 317-569-8363
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Authorized Official
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Title or Position | CCO
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Name | JEFFREY L STOCKARD
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Credential |
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Telephone | 615-377-5353
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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 | IN
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