institution
Kentucky Lake Surgery Center Llc
Ambulatory Surgical Clinic/Center in Paris, Tennessee
NPI 1033102397

Kentucky Lake Surgery Center Llc is an Ambulatory Surgical Clinic/Center based in Paris, TN and is specialized in Ambulatory Surgical. Kentucky Lake Surgery Center Llc practices in Paris, TN. The NPI Number for Kentucky Lake Surgery Center Llc is 1033102397 and holds a License No. 0000000118 (Tennessee).

The current practice location address for Kentucky Lake Surgery Center Llc is 1002 Cornerstone Dr, Paris, TN and can be reached out via phone at 731-644-2150 and via fax at 731-644-0474.

Location: 1002 Cornerstone Dr, Paris, TN, 38242-5812
institution
Provider Profile Details
NPI Number
1033102397
Provider Name
Kentucky Lake Surgery Center Llc
Credential
Provider Entity Type
Organization
Address
1002 Cornerstone Dr, Paris, TN, 38242-5812
Phone Number
731-644-2150
Fax Number
731-644-0474
Provider Enumeration Date
08/23/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3288139 05 TN
490004547 01 TN PALMETO GBA PROVIDER NUMB
3144925 01 TN BLUE CROSS PROVIDER NUMBE
institution
Provider Business Practice Location Address Details
Address
1002 Cornerstone Dr
City
State
Zip
38242-5812
Phone Number
731-644-2150
Fax Number
731-644-0474
person
Provider Business Mailing Address Details
Address
1002 Cornerstone Dr
City
State
Zip
38242-5812
Phone Number
731-644-2150
Fax Number
731-644-0474
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
License No.
0000000118 (Tennessee)
Definition
Definition to come...
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