Provider Demographics
NPI:1528099207
Name:DEER CREEK SURGERY CENTER, LLC
Entity type:Organization
Organization Name:DEER CREEK SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-897-0022
Mailing Address - Street 1:7220 W 129TH STREET
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213
Mailing Address - Country:US
Mailing Address - Phone:913-897-0022
Mailing Address - Fax:913-402-7354
Practice Address - Street 1:7220 W 129TH STREET
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213
Practice Address - Country:US
Practice Address - Phone:913-897-0022
Practice Address - Fax:913-402-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical