Provider Demographics
NPI:1386196764
Name:ADVANCED SURGICAL & RESEARCH SOLUTIONS LLC
Entity Type:Organization
Organization Name:ADVANCED SURGICAL & RESEARCH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-241-3795
Mailing Address - Street 1:3200 QUAIL SPRINGS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2698
Mailing Address - Country:US
Mailing Address - Phone:405-241-3795
Mailing Address - Fax:405-241-0996
Practice Address - Street 1:3200 QUAIL SPRINGS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-2604
Practice Address - Country:US
Practice Address - Phone:405-241-3795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-01
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical