Organization
SOUTHERN ALABAMA SURGERY CENTER LLC
Active
Other names
Surgery Center South
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARRON ALANE BYRD (ADMINISTER)
(334) 793-3411
Entity
Organization
Contact information
Practice address
2800 ROSS CLARK CIR, SUITE 3, DOTHAN, AL 36301-2040
(334) 793-3411
(334) 712-0227
Mailing address
2800 ROSS CLARK CIRCLE, SUITE 3, DOTHAN, AL 36301
(334) 793-3411
(334) 712-0227
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261Q00000X
Clinic/Center
12124
AL
261Q00000X
Clinic/Center
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000902316A
—
GA
01
—
010306
BLUE CROSS BLUE SHIELD
AL
05
—
03119876A
—
GA
05
—
062936700
—
FL
05
—
128616
—
AL
05
—
ASC0060C
—
AL
Enumeration date
09/21/2006
Last updated
10/23/2014
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