# SURGICENTER OF RACINE LTD

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

## Provider details

- **NPI number:** 1518957851
- **Authorized official:** DENNIS J KONTRA MD (DIRECTOR)
- **Authorized official phone:** (262) 886-9100

## Contact information

- **Practice address:** 5802 WASHINGTON AVE, STE 204, RACINE, WI 53406-4050
- **Practice address phone:** (261) 886-9100
- **Practice address fax:** (261) 886-9130
- **Mailing address:** 5802 WASHINGTON AVE, STE 204, RACINE, WI 53406-4050
- **Mailing address phone:** (261) 886-9100
- **Mailing address fax:** (261) 886-9130

## Taxonomy

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

## Other

- **Enumeration date:** 10/27/2005
- **Last updated:** 11/08/2016