# DODGE CITY ASC LLC

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

## Provider details

- **NPI number:** 1962660787
- **Authorized official:** WILLIAM M. GRACEY (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (615) 372-8500

## Contact information

- **Practice address:** 2203 SUMMERLON CIR, DODGE CITY, KS 67801-2985
- **Practice address phone:** (620) 408-9454
- **Practice address fax:** (620) 408-9552
- **Mailing address:** 103 POWELL CT, SUITE 200, BRENTWOOD, TN 37027-5079
- **Mailing address phone:** (615) 372-8500
- **Mailing address fax:** (615) 372-8572

## Taxonomy

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

## Other

- **Enumeration date:** 05/29/2008
- **Last updated:** 07/21/2008