Healthcare Provider Details

I. General information

NPI: 1689617953
Provider Name (Legal Business Name): ANESTHESIA SOLUTIONS OF MOBILE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 AIRPORT BLVD ANESTHESIA DEPARTMENT
MOBILE AL
36608-3709
US

IV. Provider business mailing address

PO BOX 610
FREDERICK MD
21705-0610
US

V. Phone/Fax

Practice location:
  • Phone: 251-631-3270
  • Fax: 251-631-3273
Mailing address:
  • Phone: 866-607-8693
  • Fax: 240-566-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. CLARK P. CHRISTIANSON
Title or Position: PRESIDENT
Credential:
Phone: 251-633-1660