Morehouse Ouachita Surgery Associates

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

016434 Issued in ME

Legal business name

MOREHOUSE OUACHITA SURGERY ASSOCIATES

Doing business as

The Surgery Clinic

Practice address

631 RB Wilson Dr Ste 2
Huntingdon, TN 38344-1727

Phone

(731) 358-4287

Fax

(731) 393-0098

NPI assigned

Nov 1, 2006

Last updated

May 10, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Kay Page

Title

Credentialing Manager

Phone

(731) 693-3465

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• THE SURGERY CLINIC Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Morehouse Ouachita Surgery Associates

  dba Chukwuogo Surgery Clinic

  • Clinic/Center
  • Waverly, TN
  • NPI 1558908632
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Lee Conner, MD

  • Family Medicine Physician
  • Caribou, ME
  • NPI 1093801631
  NPD (past)
• Santiago Duy, M.D.

  • Surgery Physician
  • Houlton, ME
  • NPI 1437127255
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1669559373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 RB WILSON DR STE 2",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383441727",
            "telephone_number": "731-358-4287",
            "fax_number": "731-393-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 RB WILSON DR STE 2",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383441727",
            "telephone_number": "731-358-4287",
            "fax_number": "731-393-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOREHOUSE OUACHITA SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "731-693-3465"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "016434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516071",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q048223",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SURGERY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradley Matthews, DPT
• McKenzie Medical Center PC (Hometown Health Clinic)
• Wendy Melton
• Karen Miles
• Jacinta Y Miller, APN
• Peggy Lachelle Moss, FNP
• Judi A. Murphy, RN
• Amy Naylor, FNP
• Larry Lee Nicholson II, O.D.
• Paul S Noles

• Surgery Physician in Huntingdon, TN
• Providers in Huntingdon, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.