Provider Demographics
NPI:1942484605
Name:DELOZIER SURGERY CENTER LLC
Entity type:Organization
Organization Name:DELOZIER SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOZIER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:615-565-9000
Mailing Address - Street 1:209 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1501
Mailing Address - Country:US
Mailing Address - Phone:615-565-9000
Mailing Address - Fax:615-565-9005
Practice Address - Street 1:209 23RD AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1501
Practice Address - Country:US
Practice Address - Phone:615-565-9000
Practice Address - Fax:615-565-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000165261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3739725Medicare PIN