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General NPI Number Information
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NPI Number | 1598804064
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Entity Type | Organization
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Legal Business Name | MID-AMERICA SURGERY CENTER
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6004 W KILGORE AVE
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City | MUNCIE
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State | IN
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Zip | 47304-4726
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Country | US
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Telephone | 765-284-0134
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Fax | 765-284-6770
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Provider Business Mailing Address
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Address Line | 6004 W KILGORE AVE
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City | MUNCIE
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State | IN
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Zip | 47304-4726
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Country | US
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Telephone | 765-284-0134
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Fax | 765-284-6770
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHERI L HIRST
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Credential |
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Telephone | 765-284-0134
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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 | 010353
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License Number State | IN
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