Patient Notebook

Premier Surgery Center

2511 Terra Crossing Blvd

Louisville, KY 40245

Phone: (502) 589 - 9488

Fax: (502) 254 - 3901

Make a Payment

Need to make a payment? Please fill out the information below and hit continue.

Error Summary

Please, correctly fill out all required fields.

1. Patient Information

First Name *

M.I.

Last Name *

Patient Account Number *

Date of Service Provided

Phone Number *

DOB

Email Address

A receipt will be sent to this email address.

2. Payment Amount

Amount

3. Payment Method

Credit/Debit Card

Bank Account

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel

P (502) 589 - 9488

F (502) 254 - 3901

2511 Terra Crossing Blvd

Louisville, KY 40245