# SOUTHERN INDIANA SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Indiana Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083796221
- **Authorized official:** MRS. MISTY SCALES (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (812) 333-8969

## Contact information

- **Practice address:** 2800 REX GROSSMAN BLVD, BLOOMINGTON, IN 47403-5145
- **Practice address phone:** (812) 333-8969
- **Practice address fax:** (812) 335-2309
- **Mailing address:** 2800 REX GROSSMAN BLVD, BLOOMINGTON, IN 47403-5145
- **Mailing address phone:** (812) 333-8969
- **Mailing address fax:** (812) 335-2309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 06-006102-1 | IN | Yes |

## Other

- **Enumeration date:** 10/19/2006
- **Last updated:** 03/15/2010