# BLUEMOUND SURGERY CENTER LTD

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

## Provider details

- **NPI number:** 1710107743
- **Authorized official:** DR. THOMAS G KORKOS MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (262) 970-5600

## Contact information

- **Practice address:** N4W22370 BLUEMOUND RD, WAUKESHA, WI 53186-1683
- **Practice address phone:** (262) 970-5600
- **Practice address fax:** (262) 970-5950
- **Mailing address:** N4W22370 BLUEMOUND RD, WAUKESHA, WI 53186-1683
- **Mailing address phone:** (262) 970-5600
- **Mailing address fax:** (262) 970-5950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 06/27/2012