Provider Demographics
NPI:1225523970
Name:BURNSVILLE SURGERY CENTER, P.A.
Entity Type:Organization
Organization Name:BURNSVILLE SURGERY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-841-2345
Mailing Address - Street 1:7225 OHMS LN STE 150
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2172
Mailing Address - Country:US
Mailing Address - Phone:952-222-1818
Mailing Address - Fax:952-222-1817
Practice Address - Street 1:14551 COUNTY ROAD 11 STE 110
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4735
Practice Address - Country:US
Practice Address - Phone:952-222-1818
Practice Address - Fax:952-222-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Multi-Specialty