Organization
SAINT CHARLES SURGICAL PAVILION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL GENE NORRIS MD (OWNER CEO)
(812) 634-1211
Entity
Organization
Contact information
Practice address
1900 SAINT CHARLES STREET, JASPER, IN 47546-9145
(812) 634-1211
(812) 634-9762
Mailing address
1900 SAINT CHARLES STREET, JASPER, IN 47546-9145
(812) 634-1211
(812) 634-9762
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
060025231
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200318370A
—
IN
Enumeration date
03/28/2006
Last updated
01/13/2012
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