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Organization
PLAZA SURGERY, G.P.
Active
Organization
PLAZA SURGERY, G.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN HURST (BUSINESS OFFICE MANAGER)
(423) 778-3192
Entity
Organization
Contact information
Practice address
979 E 3RD ST, CHATTANOOGA, TN 37403-2136
(423) 778-3192
(423) 778-2164
Mailing address
13740 CYPRESS TERRACE CIR, STE 501-503, FORT MYERS, FL 33907-8827
(239) 274-1000
(239) 274-1001
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000135
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3288588
—
TN
01
—
4015206
BC/BS OF TN
TN
01
—
6800041
UNITED HEALTHCARE
—
Enumeration date
06/16/2005
Last updated
12/19/2007
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