Organization
G. BAKER HUBBARD AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL E RUDD (ADMINISTRATOR)
(731) 422-0330
Entity
Organization
Contact information
Practice address
616 W FOREST AVE, JACKSON, TN 38301-3902
(731) 422-0330
(731) 422-0478
Mailing address
616 W FOREST AVE, JACKSON, TN 38301-3902
(731) 422-0330
(731) 422-0478
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000030
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3287378
—
TN
Enumeration date
03/29/2006
Last updated
08/22/2020
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