Organization
SOUTHERN SPORTS SURGICAL, LLC.
Active
Other names
Indian Lake Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GAUTSCH M.D. (CEO)
(615) 418-2975
Entity
Organization
Contact information
Practice address
127 SAUNDERSVILLE RD., SUITE A, HENDERSONVILLE, TN 37075-8902
(615) 265-8038
(615) 265-8546
Mailing address
127 SAUNDERSVILLE RD., SUITE A, HENDERSONVILLE, TN 37075-8902
(615) 265-8038
(615) 265-8546
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/10/2014
Last updated
08/19/2014
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