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General NPI Number Information
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NPI Number | 1760860977
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Entity Type | Organization
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Legal Business Name | MID MISSOURI SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1410 FORUM KATY PARKWAY SUITE 102
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City | COLUMBIA
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State | MO
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Zip | 65203
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Country | US
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Telephone | 573-441-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 FORUM KATY PARKWAY SUITE 102
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City | COLUMBIA
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State | MO
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Zip | 65203
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Country | US
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Telephone | 573-441-7070
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CHRISTY LEE
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Credential | RN
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Telephone | 573-441-7070
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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 | MO
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