Healthcare Provider Details
I. General information
NPI: 1164734612
Provider Name (Legal Business Name): HIGHLAND ANESTHESIA ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/12/2010
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
310 N WILMOT RD SUITE 309
TUCSON AZ
85711-2618
US
IV. Provider business mailing address
PO BOX 29211
PHOENIX AZ
85038-9211
US
V. Phone/Fax
- Phone: 602-273-6770
- Fax: 602-889-0483
- Phone: 602-273-6770
- Fax: 602-889-0483
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
M.
SAUCIER
Title or Position: OWNER
Credential: CRNA
Phone: 602-273-6770