Provider Demographics
NPI:1932644606
Name:INNOVATIVE SURGERY CENTER PLC
Entity Type:Organization
Organization Name:INNOVATIVE SURGERY CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAIN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDI
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUNDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-535-9777
Mailing Address - Street 1:15547 N REEMS RD BLDG A
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9583
Mailing Address - Country:US
Mailing Address - Phone:623-535-9777
Mailing Address - Fax:
Practice Address - Street 1:15547 N REEMS RD BLDG A
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9583
Practice Address - Country:US
Practice Address - Phone:623-535-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical