PHYSICIANS ALLIANCE LC NPI 1649269663

NPI Information

PHYSICIANS ALLIANCE LC is an ambulatory surgical clinic center in Cape Girardeau, MO. PHYSICIANS ALLIANCE LC NPI is 1649269663. The provider is registered as an organization entity type.
The provider Is Doing Business As Physicians Alliance Surgery Center.

The provider's business location address is:

3241 PERCY DR
CAPE GIRARDEAU, MO
ZIP 63701-901
Phone: (573) 334-1222
Fax: (573) 334-3532

The provider's authorized official is Jason C Bandermann .
The authorized official title is Administrator and has the following contact phone number (573) 334-1222.

The CLIA number assigned to this NPI record is 26D2171490 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/21/2005 and was last updated on 4/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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