Provider Demographics
NPI:1184662157
Name:WILLIAMSON SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:WILLIAMSON SURGERY CENTER, LLC
Other - Org Name:WILLIAMSON SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICARE AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-763-3859
Mailing Address - Street 1:4323 CAROTHERS PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5915
Mailing Address - Country:US
Mailing Address - Phone:615-435-7972
Mailing Address - Fax:615-435-7937
Practice Address - Street 1:4323 CAROTHERS PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5915
Practice Address - Country:US
Practice Address - Phone:615-435-7972
Practice Address - Fax:615-435-7937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000187261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00274528OtherRAILROAD MEDICARE
TN4111240OtherBLUE CROSS BLUE SHIELD
TN7770728OtherAETNA
TN3739624Medicare PIN