Organization
ELIZABETHTON SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE HOPLAND (MANAGER)
(423) 857-2066
Entity
Organization
Contact information
Practice address
106 ROGOSIN DR, ELIZABETHTON, TN 37643-2963
(423) 543-7477
(423) 543-7480
Mailing address
PO BOX 449, KINGSPORT, TN 37662-0449
(423) 857-2066
(423) 857-2030
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0003
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
02/14/2007
Last updated
08/22/2020
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