Provider Demographics
NPI:1710009550
Name:OUTPATIENT SURGERY SERVICES
Entity Type:Organization
Organization Name:OUTPATIENT SURGERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SUDEKUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-730-3000
Mailing Address - Street 1:830 WATERBURY FALLS DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-2215
Mailing Address - Country:US
Mailing Address - Phone:636-730-3000
Mailing Address - Fax:636-730-3010
Practice Address - Street 1:830 WATERBURY FALLS DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2215
Practice Address - Country:US
Practice Address - Phone:636-730-3000
Practice Address - Fax:636-730-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty