# CENTER FOR ADVANCED LAPAROSCOPIC AND BARIATRIC SURGERY, LLC

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

## Provider details

- **NPI number:** 1447446992
- **Authorized official:** JAMES BRADLEY RAY MD (PRESIDENT)
- **Authorized official phone:** (812) 330-9962

## Contact information

- **Practice address:** 506 W 2ND ST, BLOOMINGTON, IN 47403-2316
- **Practice address phone:** (812) 961-0370
- **Practice address fax:** (812) 330-9962
- **Mailing address:** 506 W 2ND ST, BLOOMINGTON, IN 47403-2316
- **Mailing address phone:** (812) 330-9962
- **Mailing address fax:** (812) 330-9967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 04046774A | IN | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 11/09/2015