Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kentucky Lake Surgery Center LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1033102397

Kentucky Lake Surgery Center LLC is an Ambulatory Surgical Clinic/Center in Paris, Tennessee. Licensed in Tennessee. Registered with an NPI since 2005.

Licensed in
TN
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1002 Cornerstone Dr Ste B
Paris, TN 38242-5812
Phone: (731) 644-2150
Fax: (731) 644-0474
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 0000000118 (TN)

Record details

NPI number1033102397
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karolyn Mobley — Administrator · (731) 644-2150
NPI enumeratedAugust 23, 2005
Last updated in NPPESJanuary 28, 2011
Mailing address1002 Cornerstone Dr, Suite B, Paris, TN 38242-5812

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