Provider Demographics
NPI:1689751976
Name:TOWER SPECIALTY SURGERY L.L.C.
Entity Type:Organization
Organization Name:TOWER SPECIALTY SURGERY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:WOOLDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:765-962-5574
Mailing Address - Street 1:1400 HIGHLAND RD
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-9239
Mailing Address - Country:US
Mailing Address - Phone:765-973-8085
Mailing Address - Fax:765-973-8076
Practice Address - Street 1:1400 HIGHLAND RD
Practice Address - Street 2:SUITE # 2
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-9239
Practice Address - Country:US
Practice Address - Phone:765-973-8085
Practice Address - Fax:765-973-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
INZR6000Medicare ID - Type Unspecified