Organization
ABERDEEN AMBULATORY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WILLIS KESSLER MD (MEDICAL DIRECTOR-MANAGING MEMBER)
(719) 565-1000
Entity
Organization
Contact information
Practice address
650 DITTMER AVENUE, PUEBLO, CO 81005-1212
(719) 565-2000
(719) 565-2222
Mailing address
650 DITTMER AVENUE, PUEBLO, CO 81005-1212
(719) 565-2000
(719) 565-2222
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0939
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06639AB
BLUE CROSS BLUE SHIELD
—
05
—
46726560
—
CO
Enumeration date
06/24/2006
Last updated
07/07/2021
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