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General NPI Number Information
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NPI Number | 1841270675
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Entity Type | Organization
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Legal Business Name | EYECARE CONSULTANTS SURGERY CENTER, LLC
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 101 NW 1ST ST SUITE 104, OLD POST OFFICE PLACE
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City | EVANSVILLE
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State | IN
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Zip | 47708-1259
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Country | US
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Telephone | 812-435-2372
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Fax | 812-435-2374
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Provider Business Mailing Address
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Address Line | 1A BURTON HILLS BLVD ATTN: L&C
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City | NASHVILLE
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State | TN
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Zip | 37215-6103
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Country | US
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Telephone | 615-665-1283
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Fax | 615-234-1720
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY SNODGRASS
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Credential |
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Telephone | 615-665-1283
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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 | 050095641
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License Number State | IN
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