# SURGERY CENTERS OF MISSOURI, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1578197927
- **Authorized official:** WILLIAM DK CRAGG (OWNER/CEO)
- **Authorized official phone:** (314) 695-8933

## Contact information

- **Practice address:** 12101 WOODCREST EXECUTIVE DR STE 101, CREVE COEUR, MO 63141-5047
- **Practice address phone:** (314) 695-8933
- **Mailing address:** 1015 S SPOEDE RD, FRONTENAC, MO 63131-2610
- **Mailing address phone:** (314) 378-2085
- **Mailing address fax:** (314) 659-8307

## Taxonomy

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

## Other

- **Enumeration date:** 02/25/2020
- **Last updated:** 02/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3142232162 | PRIVATE INSURANCE | MO |