Organization
CENTER FOR SURGICAL EXCELLENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT VAUGHAN (VP)
(540) 224-5137
Entity
Organization
Contact information
Practice address
2107 ROSALIND AVE SW, ROANOKE, VA 24014-1717
(540) 224-5135
Mailing address
PO BOX 40032, SUITE 807, ROANOKE, VA 24022-0032
(540) 224-5135
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OH709
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902847635
—
VA
Enumeration date
06/10/2006
Last updated
08/07/2012
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