Organization
NORTHLAND EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER F BRUNDIGE M.D. (PRESIDENT)
(816) 792-1900
Entity
Organization
Contact information
Practice address
100 N CLAYVIEW DR, SUITE A, LIBERTY, MO 64068-1117
(816) 792-1900
(816) 792-3548
Mailing address
100 N CLAYVIEW DR, SUITE A, LIBERTY, MO 64068-1117
(816) 792-1900
(816) 792-3548
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
183-0
MO
Other
Enumeration date
08/18/2006
Last updated
08/22/2020
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