| Organization Name: | MOBERLY SURGERY CENTER LLC |
| NPI Number: | 1144206665 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTHA WOOD (OFFICE MANAGER) |
| Mailing Address: | 2103 Silva Ln Moberly |
| State: | MO US |
| Postal Code: | 652703660 |
| Phone Number: | 6602631266 |
| Fax Number: | 6602638377 |
| NPI Enumeration Date: | 12/16/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 164-0 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |