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Organization

HAVASU SURGERY CENTER

Active
Other names
Havasu Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM M. GRACEY (COO)
(615) 372-8500
Entity
Organization

Contact information

Practice address
1775 MCCULLOCH BLVD, LAKE HAVASU CITY, AZ 86403
(928) 453-4200
(928) 453-8271
Mailing address
103 POWELL CT, STE. 200, BRENTWOOD, TN 37027-5079
(615) 372-8500
(615) 372-8572

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC2912
AZ

Other

Enumeration date
02/22/2006
Last updated
08/22/2020
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