# OUTPATIENT SURGERY CENTER OF LAKEWOOD LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakewood Surgical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467415950
- **Authorized official:** DON LIEDTKE (VICE PRESIDENT)
- **Authorized official phone:** (615) 344-5507

## Contact information

- **Practice address:** 2201 WADSWORTH BLVD, LAKEWOOD, CO 80214-5708
- **Practice address phone:** (303) 234-0445
- **Practice address fax:** (303) 232-7182
- **Mailing address:** 2201 WADSWORTH BLVD, LAKEWOOD, CO 80214-5708
- **Mailing address phone:** (303) 234-0445
- **Mailing address fax:** (303) 232-7182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0672 | CO | Yes |

## Other

- **Enumeration date:** 04/07/2006
- **Last updated:** 10/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04510038 | — | CO |