Ambulatory Surgery Center of Centralia, LLC

NPI #1265495824 in Centralia, Illinois

Provider Information

NPI Number: 1265495824
Entity Type: Organization
Organization Name: Ambulatory Surgery Center of Centralia, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Apr 6, 2006
Last Updated: Feb 5, 2024

Practice Location

Address: 1045 MARTIN LUTHER KING DR
City: Centralia
State: Illinois
ZIP Code: 62801-3001
Phone: (618) 532-3110

Authorized Official

Name: UDAYA LIYANAGE, MD
Title: PRESIDENT
Phone: (618) 899-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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