Organization
SURGICAL SERVICES OF SEDALIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY K WILLIAMS (OFFICE MANAGER)
(660) 827-0423
Entity
Organization
Contact information
Practice address
3300 W 10TH ST, SEDALIA, MO 65301-2111
(660) 827-0423
(660) 827-5510
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13161010
BLUE KC
MO
Enumeration date
03/03/2008
Last updated
07/21/2022
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