# INDIANA SPECIALTY SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1174777817
- **Authorized official:** DR. GREGORY M FOX M.D. (CEO)
- **Authorized official phone:** (812) 333-4000

## Contact information

- **Practice address:** 1380 W ARCH HAVEN AVE, BLOOMINGTON, IN 47403-2055
- **Practice address phone:** (812) 330-1164
- **Practice address fax:** (812) 332-5102
- **Mailing address:** 1380 W ARCH HAVEN AVE, BLOOMINGTON, IN 47403-2055
- **Mailing address phone:** (812) 330-1164
- **Mailing address fax:** (812) 332-5102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2008
- **Last updated:** 11/07/2008