EXHIBIT 10.4



                               SECOND AMENDMENT TO
                 AMENDED AND RESTATED REVOLVING CREDIT AGREEMENT


         THIS SECOND AMENDMENT TO AMENDED AND RESTATED REVOLVING CREDIT
AGREEMENT (this "Amendment") is made and entered into as of February 5, 2003 by
and among AMSURG CORP., a Tennessee corporation (the "Borrower"), the several
banks and other financial institutions from time to time party hereto (the
"Lenders"), and SUNTRUST BANK, in its capacity as Administrative Agent for the
Lenders (the "Administrative Agent").

                                    RECITALS:

         1.       The Borrower, Lenders and Administrative Agent entered into
that certain Amended and Restated Revolving Credit Agreement dated May 5, 2000,
as amended by that certain First Amendment to Amended and Restated Revolving
Credit Agreement dated June 22, 2001 (as amended, the "Agreement").


         2.       The Borrower and Lender desire to further amend the Agreement
as provided herein.

         NOW, THEREFORE, in consideration of the premises and for other good and
valuable consideration, the Borrower, the Lenders and the Administrative Agent
agree as follows:

         1.       Section 7.5 of the Agreement is hereby amended and restated as

follows:

                  SECTION 7.5 RESTRICTED PAYMENTS. Except for dividends payable
         from a Wholly Owned Subsidiary to the Borrower, the Borrower will not,
         and will not permit any of its corporate Subsidiaries to, declare or
         make, or agree to pay or make, directly or indirectly, any dividend on
         any class of its stock, or make any payment on account of, or set
         apart assets for a sinking or other analogous fund for, the purchase
         redemption, retirement, defeasance or other acquisition of, any shares
         of treasury stock (each, a "Restricted Payment"); provided however the
         Borrower shall be permitted to purchase in the aggregate during the
         term of this Agreement treasury stock totaling no greater than
         $25,000,000.

         2.       The Agreement is not amended in any other respect.

         3.       The Borrower represents and warrants that no Event of Default
has occurred and is continuing under the Agreement

         4.       The Borrower agrees that its obligations are valid and
binding, enforceable in accordance with their respective terms, subject to no
defense, counterclaim, or objection.

         5.       This Amendment may be executed in any number of separate
counterparts (including by telecopy), and all of said counterparts taken
together shall be deemed to constitute one and the same instrument and will be
effective upon execution by Borrower, Administrative Agent and the Required
Lenders.

         IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be
duly executed by their respective authorized officers as of the day and year
first above written.


                                             BORROWER:

                                             AMSURG CORP.



                                             By: /s/ Claire M. Gulmi
                                                 ------------------------------

                                             Title: CFO
                                                    ---------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                             SUNTRUST BANK
                                             as Administrative Agent, as Issuing
                                             Bank, and as a Lender



                                             By: /s/ Mark D. Matthew
                                                 ------------------------------

                                             Title: Director
                                                    ---------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                             BANK OF AMERICA, N.A.,
                                             as Syndication Agent and as a
                                             Lender



                                             By: /s/ Elizabeth L. Knox
                                                 ------------------------------

                                             Title: Senior Vice President
                                                    ---------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                           US BANK, NATIONAL ASSOCIATION,
                                           successor-in-interest to Firstar
                                           Bank, N.A., as a Lender



                                           By: /s/ S.W. Choppin
                                               -------------------------------

                                           Title: Senior Vice President
                                                  ----------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                             AMSOUTH BANK,
                                             as a Lender


                                             By: /s/ William H. Berrell
                                                 ------------------------------

                                             Title: Vice President
                                                    ---------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                    STANDARD FEDERAL, N.A.,
                                    successor-in-interest to Michigan
                                    National Bank, as a Lender


                                    By: /s/ Ralph P. Binggeser
                                        -----------------------------------

                                    Title: Commercial Relationship Manager
                                           -------------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                             BANK OF OKLAHOMA, N.A.,
                                             as a Lender


                                             By: /s/ Heather E. Williams
                                                 ------------------------------

                                             Title: Assistant Vice President
                                                    ---------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                             FIRST TENNESSEE BANK, NATIONAL
                                             ASSOCIATION, as a Lender


                                             By: Deryl J. Bauman
                                                 ------------------------------

                                             Title: Vice President
                                                    ---------------------------



                      [SIGNATURES CONTINUED ON NEXT PAGE]

                                             KEY CORPORATE CAPITAL, INC., as a
                                             Lender


                                             By: /s/ Wendy Butler
                                                 ------------------------------

                                             Title: Vice President
                                                    ---------------------------