Organization
SURGERY CLINIC, LLC
Active
Parent organization
THE SURGERY CLINIC, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE SURGERY CLINIC, LLC
Authorized official
MRS. DIANETTE KEENER (BILLING MANAGER)
(256) 547-6331
Entity
Organization
Contact information
Practice address
395 NORTHWOOD DR, CENTRE, AL 35960-1045
(256) 547-6331
(256) 547-1711
Mailing address
419 S 5TH ST, GADSDEN, AL 35901-5101
(256) 547-6331
(256) 547-1711
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128498
—
AL
Enumeration date
04/07/2011
Last updated
08/17/2011
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