Healthcare Provider Details

I. General information

NPI: 1700853421
Provider Name (Legal Business Name): OTTUMWA ANESTHESIOLOGISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 E ALTA VISTA AVE
OTTUMWA IA
52501-1413
US

IV. Provider business mailing address

312 E ALTA VISTA AVE
OTTUMWA IA
52501-1413
US

V. Phone/Fax

Practice location:
  • Phone: 641-682-4115
  • Fax: 641-682-0005
Mailing address:
  • Phone: 641-682-4115
  • Fax: 641-682-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SHASHI C SANGHNI
Title or Position: PRESIDENT
Credential: MD
Phone: 641-682-4115