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General NPI Number Information
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NPI Number | 1588659411
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Entity Type | Organization
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Legal Business Name | TRI-LAKES SURGERY CENTER, LLC
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 915 HIGHWAY 248 SUITE B
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City | BRANSON
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State | MO
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Zip | 65616-8154
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Country | US
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Telephone | 417-335-8572
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Fax | 417-335-8573
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Provider Business Mailing Address
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Address Line | 915 HIGHWAY 248 SUITE B
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City | BRANSON
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State | MO
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Zip | 65616-8154
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Country | US
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Telephone | 417-335-8572
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Fax | 417-335-8573
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | TOM V MORRISON
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Credential | M.D.
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Telephone | 417-335-8572
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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 | 168-0
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License Number State | MO
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