Provider Demographics
NPI:1477853901
Name:ANDERSON SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ANDERSON SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUKARRAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:513-624-7246
Mailing Address - Street 1:7691 5 MILE RD
Mailing Address - Street 2:SUITE 10 B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4348
Mailing Address - Country:US
Mailing Address - Phone:513-624-7246
Mailing Address - Fax:937-624-6900
Practice Address - Street 1:7691 5 MILE RD
Practice Address - Street 2:SUITE 10 B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4348
Practice Address - Country:US
Practice Address - Phone:513-624-7246
Practice Address - Fax:937-624-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical