Organization
GP SURGERY CENTER, LLC
Active
Other names
Great Plains Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE L. REED (AUTHORIZED OFFICIAL)
(972) 763-3859
Entity
Organization
Contact information
Practice address
5404 SOUTHWEST LEE BOULEVARD, SUITE 100, LAWTON, OK 73505-9521
(580) 536-7533
(580) 536-7535
Mailing address
5404 SOUTHWEST LEE BOULEVARD, SUITE 100, LAWTON, OK 73505-9521
(580) 536-7533
(580) 536-7535
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0027
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000371019001
BLUE CROSS PROVIDER NUMBE
OK
01
—
000371019001
BLUE CROSS
—
05
—
200008100A
—
OK
01
—
490005778
RAILROAD MEDICARE
OK
Enumeration date
07/12/2005
Last updated
11/19/2009
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