Provider Demographics
NPI:1053313007
Name:CHILDRENS SURGERY CENTER
Entity Type:Organization
Organization Name:CHILDRENS SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:614-722-2920
Mailing Address - Street 1:660 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2649
Mailing Address - Country:US
Mailing Address - Phone:614-722-2920
Mailing Address - Fax:614-722-5710
Practice Address - Street 1:660 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2649
Practice Address - Country:US
Practice Address - Phone:614-722-2920
Practice Address - Fax:614-722-5710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH334261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3610921Medicare ID - Type UnspecifiedAMBULATORY SURGERY CENTER