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Organization
SOUTHERN SPORTS SURGICAL, LLC.
Active
Organization
SOUTHERN SPORTS SURGICAL, LLC.
Active
Other names
Indian Lake Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GAUTSCH M.D. (CEO)
(615) 418-2975
Entity
Organization
Contact information
Practice address
127 SAUNDERSVILLE RD., SUITE A, HENDERSONVILLE, TN 37075-8902
(615) 265-8038
(615) 265-8546
Mailing address
127 SAUNDERSVILLE RD., SUITE A, HENDERSONVILLE, TN 37075-8902
(615) 265-8038
(615) 265-8546
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2014
Last updated
08/19/2014
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