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General NPI Number Information
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NPI Number | 1891717823
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Entity Type | Organization
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Legal Business Name | AMBULATORY SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 501 DOCTORS CT
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City | OSHKOSH
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State | WI
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Zip | 54901-2025
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Country | US
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Telephone | 920-236-3550
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Fax | 920-236-3548
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Provider Business Mailing Address
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Address Line | 2120 S WASHBURN ST
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City | OSHKOSH
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State | WI
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Zip | 54904
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Country | US
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Telephone | 920-236-3550
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Fax | 920-238-3169
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ERIC LARSON
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Credential | M.D.
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Telephone | 920-236-3550
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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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