Healthcare Provider Details

I. General information

NPI: 1649265810
Provider Name (Legal Business Name): ANESTHESIA SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

PO BOX 11407 DEPT 1499
BIRMINGHAM AL
35246-1499
US

V. Phone/Fax

Practice location:
  • Phone: 251-432-4497
  • Fax: 251-432-0577
Mailing address:
  • Phone: 800-897-6169
  • Fax: 800-897-6170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD H JORDAN
Title or Position: PRESIDENT
Credential: MD
Phone: 251-432-4497