| Organization Name: | JCMG SURGERY CENTER, INC. |
| NPI Number: | 1023169380 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL CRAIGHEAD (COO) |
| Mailing Address: | 1241 W Stadium Blvd Jefferson City |
| State: | MO US |
| Postal Code: | 651096023 |
| Phone Number: | 5735567760 |
| Fax Number: | 5737611470 |
| NPI Enumeration Date: | 01/15/2007 |
| NPI Last Update Date: | 09/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |