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General NPI Number Information
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NPI Number | 1720041254
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Entity Type | Organization
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Legal Business Name | ATRIUM SURGERY CENTER, LTD., A TENNESSEE LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 1949 GUNBARREL RD SUITE 290
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3188
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Country | US
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Telephone | 423-495-3551
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Fax | 423-495-3596
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Provider Business Mailing Address
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Address Line | 1949 GUNBARREL RD SUITE 290
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3188
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Country | US
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Telephone | 423-495-3551
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Fax | 423-495-3596
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DON LIEDTKE
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Credential |
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Telephone | 615-344-5507
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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 | 0000000063
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License Number State | TN
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