Organization
FAIRLAWN SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN D EVANS MD (CO-MEDICAL DIRECTOR)
(540) 904-6170
Entity
Organization
Contact information
Practice address
2030 STEPHENSON AVE SW, ROANOKE, VA 24014-1664
(540) 904-6170
(540) 904-6177
Mailing address
2030 STEPHENSON AVE SW, ROANOKE, VA 24014-1664
(540) 904-6170
(540) 904-6177
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2010
Last updated
08/09/2016
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