Provider Demographics
NPI:1457957391
Name:MIDDLEBROOK ASC, LLC
Entity Type:Organization
Organization Name:MIDDLEBROOK ASC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, PHYSICIAN BUSINESS SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-604-8726
Mailing Address - Street 1:4000 MERIDIAN BLVD
Mailing Address - Street 2:PATTY BOU- 2 NORTH ASC
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:702-271-8476
Mailing Address - Fax:
Practice Address - Street 1:1210 TENNOVA MEDICAL
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909
Practice Address - Country:US
Practice Address - Phone:702-271-8476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical