Healthcare Provider Details

I. General information

NPI: 1568974327
Provider Name (Legal Business Name): CAHABA VALLEY ANESTHESIA SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 2ND STREET NORTH
ALABASTER AL
35007
US

IV. Provider business mailing address

1114 HARRIET ST
CLANTON AL
35045-8474
US

V. Phone/Fax

Practice location:
  • Phone: 334-202-9397
  • Fax:
Mailing address:
  • Phone: 334-202-9397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM RICHARD NEWTON
Title or Position: PRESIDENT
Credential: CRNA
Phone: 334-202-9397