Provider Demographics
NPI:1982211728
Name:FT SCOTT SURGERY CENTER LLC
Entity Type:Organization
Organization Name:FT SCOTT SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-729-5602
Mailing Address - Street 1:11184 ANTIOCH RD STE 356
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2420
Mailing Address - Country:US
Mailing Address - Phone:913-787-6724
Mailing Address - Fax:
Practice Address - Street 1:918 HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-8885
Practice Address - Country:US
Practice Address - Phone:620-223-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty