# SURGERY CENTER OF LEAWOOD, LLC

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

## Provider details

- **NPI number:** 1437237401
- **Authorized official:** THOMAS CHARLES BOLDRY DPM (CEO)
- **Authorized official phone:** (816) 260-7893

## Contact information

- **Practice address:** 11413 ASH ST STE 100, LEAWOOD, KS 66211-1692
- **Practice address phone:** (913) 661-9977
- **Practice address fax:** (913) 661-9577
- **Mailing address:** 11413 ASH ST STE 100, LEAWOOD, KS 66211-1692
- **Mailing address phone:** (913) 661-9977
- **Mailing address fax:** (913) 661-9577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | S046016 | KS | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | S046016 | STATE LICENSE NUMBER | SC |