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Organization

AD ASTRA EYE SURGERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
M. SCOTT HICKMAN MD (MEDICAL DIRECTOR)
(785) 424-8805
Entity
Organization

Contact information

Practice address
4955 RESEARCH PARK WAY, LAWRENCE, KS 66047
(785) 424-8805
Mailing address
4955 RESEARCH PARK WAY, LAWRENCE, KS 66047
(785) 424-8805

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
261QS0132X
Ophthalmologic Surgery Clinic/Center

Other

Enumeration date
11/21/2022
Last updated
07/26/2023
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