Provider Demographics
NPI:1306084900
Name:SEVEN OAKS SURGERY CENTER, LLC
Entity type:Organization
Organization Name:SEVEN OAKS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROTTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-966-8880
Mailing Address - Street 1:214 LINDEMAN
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3511
Mailing Address - Country:US
Mailing Address - Phone:314-966-8880
Mailing Address - Fax:314-966-5811
Practice Address - Street 1:13627 BIG BEND ROAD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-0000
Practice Address - Country:US
Practice Address - Phone:314-966-8880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical