Advanced Surgery of Indiana LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Indianapolis, IN
NPI 1669816799 · NPPES record last updated Apr 19, 2013
Key facts
- NPI
- 1669816799
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 01068514A (IN)
- Legal business name
- ADVANCED SURGERY OF INDIANA LLC
- Practice address
- 9470 Bridgewater Cir
Indianapolis, IN 46250-3412 - Phone
- (317) 598-0094
- NPI assigned
- Apr 19, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Scott Edward Mimms, M.D.
- Title
- Surgeon
- Phone
- (317) 679-1757
Practitioners 1
National Provider Directory
Locations
6470 N Shadeland Ave
Ste D
Indianapolis, IN 46220
Phone (317) 598-0094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 01068514A | IN | Yes |
Addresses
Primary practice location
9470 Bridgewater Cir
Indianapolis, IN 46250-3412
Mailing address
PO Box 56051
Indianapolis, IN 46256-0051
Phone (317) 598-0094
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200986830 | Medicaid | IN |
Other providers in Indianapolis, IN
- Advanced Physical Therapy, LLC
- Advanced Physical Therapy, LLC
- Advanced Physical Therapy, LLC
- Advanced Primary Care Associates
- Advanced Psa Family Center
- Advanced Urology LLC
- Advancing Residential Care
- Sunil S Advani
- Advantage Care Chiropractic LLC
- Advantage Health Solutions
All providers in Indianapolis, IN · Ambulatory Surgical Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.