| NPI | 1154359735 |
|---|---|
| Doing Business As | SOUTHPARK SURGICARE |
| Entity Type | Organization |
| Authorized Contact | GERALD GLYNN EDDS Owner 270-926-9033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 300176) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2010-11-30 |