MEDICARE: PODSURG, 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	:	1497885198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODSURG, LLC

Provider Business Mailing Address
First Line	:	1670 W SUNSET AVE
Second Line	:	SUITE A
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-5136
Country	:	US
Telephone Number	:	479-750-3131
Fax Number	:	479-750-9631

Provider Business Practice Location Address
First Line	:	1670 W SUNSET AVE
Second Line	:	SUITE A
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-5136
Country	:	US
Telephone Number	:	479-750-3131
Fax Number	:	479-750-9631

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEAN E BRIGHT
Credential	:
Telephone Number	:	479-750-3131

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/22/2020

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