Healthcare Provider Details

I. General information

NPI: 1184097313
Provider Name (Legal Business Name): EPIX ANESTHESIA OF GEORGIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 PAULSEN ST
SAVANNAH GA
31405-3662
US

IV. Provider business mailing address

1080 HOLCOMB BRIDGE RD BUILDING 100 STE 330
ROSWELL GA
30076-4346
US

V. Phone/Fax

Practice location:
  • Phone: 844-793-1380
  • Fax: 770-559-1231
Mailing address:
  • Phone: 844-793-1380
  • Fax: 770-559-1231

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
# 3
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name: TIM ADAMS
Title or Position: OWNER
Credential: MD
Phone: 678-580-1349