| Organization Name: | VESTAVIA SURGICAL CENTER, LLC |
| NPI Number: | 1114367604 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN R KINGSLEY (PRESIDENT & OWNER) |
| Mailing Address: | 700 Montgomery Hwy Suite 210 Vestavia |
| State: | AL US |
| Postal Code: | 352161866 |
| Phone Number: | 2058230150 |
| Fax Number: | 2058235218 |
| NPI Enumeration Date: | 06/27/2013 |
| NPI Last Update Date: | 06/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 443871 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |