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General NPI Number Information
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NPI Number | 1881651206
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Entity Type | Organization
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Legal Business Name | GATEWAY SURGERY CENTER, L.L.C.
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 841 SPRINGDALE DR
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City | CLINTON
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State | IA
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Zip | 52732-3579
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Country | US
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Telephone | 563-244-9955
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Fax | 563-243-3461
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Provider Business Mailing Address
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Address Line | 841 SPRINGDALE DR
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City | CLINTON
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State | IA
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Zip | 52732-3579
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Country | US
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Telephone | 563-244-9955
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Fax | 563-243-3461
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | THOMAS A. MOSER
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Credential |
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Telephone | 563-243-2511
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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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