Organization
MOREHOUSE OUACHITA SURGERY ASSOCIATES
Active
Other names
THE SURGERY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KAY PAGE (CREDENTIALING MANAGER)
(731) 693-3465
Entity
Organization
Contact information
Practice address
631 RB WILSON DR STE 2, HUNTINGDON, TN 38344-1727
(731) 358-4287
(731) 393-0098
Mailing address
631 RB WILSON DR STE 2, HUNTINGDON, TN 38344-1727
(731) 358-4287
(731) 393-0098
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
016434
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516071
—
TN
05
—
Q048223
—
TN
Enumeration date
11/01/2006
Last updated
05/10/2019
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