Healthcare Provider Details

I. General information

NPI: 1811187347
Provider Name (Legal Business Name): PACES ANESTHESIA ACCOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 DOWNWOOD CIR NW SUITE 640
ATLANTA GA
30327-1610
US

IV. Provider business mailing address

3200 DOWNWOOD CIR NW SUITE 640
ATLANTA GA
30327-1610
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-0051
  • Fax: 404-351-0632
Mailing address:
  • Phone: 404-351-0051
  • Fax: 404-351-0632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHERRI CANNON
Title or Position: BUSINESS OFFICE
Credential:
Phone: 404-351-0051