KENTUCKY LAKE SURGERY CENTER LLC
Surgery Yellow Pages
Paris, Tennessee
Provider NPI: 1033102397
Organization Information:Organization Name: KENTUCKY LAKE SURGERY CENTER LLC
Practice Location:
1002 CORNERSTONE DR SUITE B PARIS, TN 38242 US
Tel: 731-644-2150 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1002 CORNERSTONE DR SUITE B PARIS, TN 38242 US
Tel: 731-644-2150 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | TN | 0000000118 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
3288139 | TN | 05 | |
PALMETO GBA PROVIDER NUMB | 490004547 | TN | 01 |
BLUE CROSS PROVIDER NUMBE | 3144925 | TN | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin