# ABERDEEN AMBULATORY SURGICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194751784
- **Authorized official:** CHARLES WILLIS KESSLER MD (MEDICAL DIRECTOR-MANAGING MEMBER)
- **Authorized official phone:** (719) 565-1000

## Contact information

- **Practice address:** 650 DITTMER AVENUE, PUEBLO, CO 81005-1212
- **Practice address phone:** (719) 565-2000
- **Practice address fax:** (719) 565-2222
- **Mailing address:** 650 DITTMER AVENUE, PUEBLO, CO 81005-1212
- **Mailing address phone:** (719) 565-2000
- **Mailing address fax:** (719) 565-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0939 | CO | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 07/07/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 06639AB | BLUE CROSS BLUE SHIELD | — |
| 05 | — | 46726560 | — | CO |