Healthcare Provider Details
I. General information
NPI: 1003111667
Provider Name (Legal Business Name): GI ANESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2011
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
748 OLD NORCROSS RD SUITE 250
LAWRENCEVILLE GA
30046-3393
US
IV. Provider business mailing address
5700 MIDNIGHT PASS RD SUITE 4
SARASOTA FL
34242-3083
US
V. Phone/Fax
- Phone: 770-682-7220
- Fax: 770-338-0410
- Phone: 888-337-3509
- Fax: 941-328-3997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
J
MORRIS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 404-253-6820