# ADVANCED SURGERY OF INDIANA LLC

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

## Provider details

- **NPI number:** 1669816799
- **Authorized official:** DR. SCOTT EDWARD MIMMS M.D. (SURGEON)
- **Authorized official phone:** (317) 679-1757

## Contact information

- **Practice address:** 9470 BRIDGEWATER CIR, INDIANAPOLIS, IN 46250-3412
- **Practice address phone:** (317) 598-0094
- **Mailing address:** PO BOX 56051, INDIANAPOLIS, IN 46256-0051
- **Mailing address phone:** (317) 598-0094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 01068514A | IN | Yes |

## Other

- **Enumeration date:** 04/19/2013
- **Last updated:** 04/19/2013