Provider Demographics
NPI:1275142804
Name:ATLAS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ATLAS SURGERY CENTER, LLC
Other - Org Name:ATLAS SURGERY CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:BAZHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-270-6658
Mailing Address - Street 1:1200 CHASKA CREEK WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2749
Mailing Address - Country:US
Mailing Address - Phone:952-495-6740
Mailing Address - Fax:952-495-6744
Practice Address - Street 1:3000 HUNDERTMARK RD STE 200
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1152
Practice Address - Country:US
Practice Address - Phone:952-495-6740
Practice Address - Fax:952-466-3936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical