MEDICARE: METRIC ANESTHESIA CONSULTANTS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	1092142	KY

General Provider Information

NPI Number	:	1740584465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRIC ANESTHESIA CONSULTANTS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 6899
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40206-0899
Country	:	US
Telephone Number	:	502-640-8349
Fax Number	:	502-749-9202

Provider Business Practice Location Address
First Line	:	4034 SAINT IVES CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-3814
Country	:	US
Telephone Number	:	502-640-8349
Fax Number	:	502-749-9202

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	TARA M BOWLING
Credential	:	CPC
Telephone Number	:	502-727-9397

Provider Enumeration Date	:	01/10/2011
Last Update Date	:	01/19/2011

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