Organization
FRY EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM S CLIFFORD M.D. (AUTHORIZED OFFICIAL/OWNER)
(620) 275-7248
Entity
Organization
Contact information
Practice address
411 CAMPUS DRIVE, GARDEN CITY, KS 67846-6124
(620) 276-7699
(620) 276-7704
Mailing address
411 CAMPUS DRIVE, GARDEN CITY, KS 67846-6124
(620) 276-7699
(620) 276-7704
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100305010A
—
KS
05
—
100750170A
—
OK
05
—
94510021
—
CO
Enumeration date
07/24/2006
Last updated
08/10/2015
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