| Organization Name: | SURGERY CLINIC, LLC |
| NPI Number: | 1851681183 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANETTE KEENER (BILLING MANAGER) |
| Mailing Address: | 395 Northwood Dr Centre |
| State: | AL US |
| Postal Code: | 359601045 |
| Phone Number: | 2565476331 |
| Fax Number: | 2565471711 |
| NPI Enumeration Date: | 04/07/2011 |
| NPI Last Update Date: | 08/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |