Provider Demographics
NPI:1427544667
Name:CENTER FOR SPECIALTY SURGERY OF COLUMBUS, LLC
Entity Type:Organization
Organization Name:CENTER FOR SPECIALTY SURGERY OF COLUMBUS, LLC
Other - Org Name:CENTER FOR SPECIALTY SURGERY OF COLUMBUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDFORD
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SCHOCKET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-992-7246
Mailing Address - Street 1:7951 SHOAL CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7534
Mailing Address - Country:US
Mailing Address - Phone:512-467-7246
Mailing Address - Fax:
Practice Address - Street 1:5040 FOREST DR STE 230
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8167
Practice Address - Country:US
Practice Address - Phone:512-467-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty