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Organization
MCPEAK SURGERY CENTER LLC
Active
Organization
MCPEAK SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER WITCHER MD (OWNER)
(270) 651-2181
Entity
Organization
Contact information
Practice address
108 BRAVO BLVD, GLASGOW, KY 42141-3478
(270) 651-2181
(270) 651-2183
Mailing address
108 BRAVO BLVD, GLASGOW, KY 42141-3478
(270) 651-2181
(270) 651-2183
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300060
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36000826
—
KY
Enumeration date
10/25/2005
Last updated
05/12/2017
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