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General NPI Number Information
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NPI Number | 1962580266
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Entity Type | Organization
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Legal Business Name | NOVAMED SURGERY CENTER OF WARRENSBURG LLC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 506 BURKARTH RD SUITE B
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City | WARRENSBURG
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State | MO
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Zip | 64093-3104
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Country | US
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Telephone | 660-747-1888
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Fax | 660-747-1223
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Provider Business Mailing Address
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Address Line | 506 BURKARTH RD
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City | WARRENSBURG
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State | MO
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Zip | 64093-3104
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Country | US
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Telephone | 660-747-1888
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Fax | 660-747-1223
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5954
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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 | 194-0
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License Number State | MO
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