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General NPI Number Information
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NPI Number | 1790443950
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Entity Type | Organization
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Legal Business Name | KOKOMO CENTER FOR OUTPATIENT SURGERY LLC
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 1907 W SYCAMORE ST STE 110
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City | KOKOMO
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State | IN
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Zip | 46901-5148
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Country | US
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Telephone | 615-491-0511
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 W SYCAMORE ST
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City | KOKOMO
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State | IN
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Zip | 46901-5148
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Country | US
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Telephone | 765-210-1411
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Fax | 765-681-5061
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | AARON LEGRAND
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Credential | MD
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Telephone | 765-860-9072
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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 |
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