MEDICARE: DODGE CITY ASC 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	:	1962660787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DODGE CITY ASC LLC

Provider Business Mailing Address
First Line	:	103 POWELL CT
Second Line	:	SUITE 200
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5079
Country	:	US
Telephone Number	:	615-372-8500
Fax Number	:	615-372-8572

Provider Business Practice Location Address
First Line	:	2203 SUMMERLON CIR
Second Line	:
City	:	DODGE CITY
State	:	KS
Zip	:	67801-2985
Country	:	US
Telephone Number	:	620-408-9454
Fax Number	:	620-408-9552

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	WILLIAM M. GRACEY
Credential	:
Telephone Number	:	615-372-8500

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	07/21/2008

Similar Medicare Providers

1518959295 — DR. BONNIE JEAN LEES MD
Practice Location Address:

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398

1013915685 — SURGERY CENTER OF DODGE CITY, LLC
Practice Location Address:

2203 SUMMERLON CIR
DODGE CITY, KS
67801-2985

Practice Phone: 620-408-9454
Practice Fax: 620-408-9552

1891740361 — KANSAS CITY VA CLINIC
Practice Location Address:

2201 SUMMERLON CIR
DODGE CITY, KS
67801-2985

Practice Phone: 913-578-4409
Practice Fax:

1881611713 — ANESTHESIA CRITICAL CARE NURSING,PA
Practice Location Address:

2203 SUMMERLON CIR
DODGE CITY, KS
67801-2985

Practice Phone: 620-408-9454
Practice Fax: 620-408-9552

1265608798 — MRS. DANA MARIE HOWERTON APRN
Practice Location Address:

2201 SUMMERLON CIR
DODGE CITY, KS
67801-2985

Practice Phone: 620-225-7146
Practice Fax: 620-225-2689

1659835577 — KIMBERLY HOUSMAN
Practice Location Address:

2201 SUMMERLON CIR
DODGE CITY, KS
67801-2985

Practice Phone: 620-225-7146
Practice Fax:

Directions to “DODGE CITY ASC LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.