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General NPI Number Information
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NPI Number | 1982696894
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Entity Type | Organization
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Legal Business Name | AFFILIATED AMBULATORY SURGERY CENTER LLC
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 650 SHAWAN FALLS DR
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City | DUBLIN
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State | OH
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Zip | 43017-2100
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Country | US
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Telephone | 614-764-1711
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Fax | 614-889-2652
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Provider Business Mailing Address
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Address Line | 650 SHAWAN FALLS DR
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City | DUBLIN
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State | OH
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Zip | 43017-2100
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Country | US
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Telephone | 614-764-1711
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Fax | 614-889-2652
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DWIGHT A SCARBOROUGH
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Credential | M.D.
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Telephone | 614-764-1711
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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 | 0059AS
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License Number State | OH
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