Organization
CLARKSVILLE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT MONTGOMERY (AUTHORIZED OFFICIAL)
(931) 645-1373
Entity
Organization
Contact information
Practice address
793 WEATHERLY DR, CLARKSVILLE, TN 37043-8942
(931) 542-2915
(931) 648-1816
Mailing address
793 WEATHERLY DR, CLARKSVILLE, TN 37043-8942
(931) 542-2915
(931) 648-1816
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000095
TN
261QM1300X
Multi-Specialty Clinic/Center
0000000095
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3119020
BLUE CROSS
TN
05
—
3119020
—
TN
Enumeration date
06/06/2006
Last updated
01/06/2026
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