| Clarksville Surgery Center Llc | |
|
793 Weatherly Dr Clarksville TN 37043-8942 | |
| (931) 542-2915 | |
| (931) 648-1816 |
| Full Name | Clarksville Surgery Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 793 Weatherly Dr, Clarksville, Tennessee |
| Authorized Official Name and Position | Kristen Oconnor (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6153767315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clarksville Surgery Center Llc 793 Weatherly Dr Clarksville TN 37043-8942 Ph: (931) 542-2915 | Clarksville Surgery Center Llc 793 Weatherly Dr Clarksville TN 37043-8942 Ph: (931) 542-2915 |
| NPI Number | 1487693123 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 11/08/2024 |
| Medicare PECOS PAC ID | 5193726990 |
|---|---|
| Medicare Enrollment ID | O20080721000549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487693123 | NPI | - | NPPES |
| 3119020 | Other | TN | BLUE CROSS |
| 3119020 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 0000000095 (Tennessee) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | 0000000095 (Tennessee) | Primary |
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