Provider Demographics
NPI:1356646715
Name:ZACHARY ASC PARTNERS, LLC
Entity Type:Organization
Organization Name:ZACHARY ASC PARTNERS, LLC
Other - Org Name:ZACHARY ASC PARTNERS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:225-570-2807
Mailing Address - Street 1:2421 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2710
Mailing Address - Country:US
Mailing Address - Phone:225-570-2804
Mailing Address - Fax:225-654-0791
Practice Address - Street 1:6550 MAIN ST STE 2600
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-4092
Practice Address - Country:US
Practice Address - Phone:225-570-2804
Practice Address - Fax:225-654-0791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD021383261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical