MEDICARE: ADVANCED SURGICAL & RESEARCH SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1386196764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED SURGICAL & RESEARCH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3200 QUAIL SPRINGS PKWY STE 100
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2698
Country	:	US
Telephone Number	:	405-241-3795
Fax Number	:	405-241-0996

Provider Business Practice Location Address
First Line	:	3200 QUAIL SPRINGS PKWY
Second Line	:	SUITE 200
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2604
Country	:	US
Telephone Number	:	405-241-3795
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	AMANDA STANLEY
Credential	:	RN
Telephone Number	:	405-241-3795

Provider Enumeration Date	:	11/01/2016
Last Update Date	:	07/10/2019

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