Organization
SURGCO, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KAY PAGE (CREDENTIALING MANAGER)
(731) 693-3465
Entity
Organization
Contact information
Practice address
107 GLEN OAK BLVD STE 201A, HENDERSONVILLE, TN 37075-3000
(615) 757-3367
(615) 757-3426
Mailing address
107 GLEN OAK BLVD STE 201A, HENDERSONVILLE, TN 37075-3000
(615) 757-3451
(615) 757-3296
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3000357
—
TN
05
—
Q059943
—
TN
Enumeration date
08/24/2020
Last updated
11/30/2020
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