Healthcare Provider Details

I. General information

NPI: 1952683625
Provider Name (Legal Business Name): TWIN FALLS ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 FALLS AVE W
TWIN FALLS ID
83301-3115
US

IV. Provider business mailing address

PO BOX 1657
TWIN FALLS ID
83303-1657
US

V. Phone/Fax

Practice location:
  • Phone: 208-734-3356
  • Fax: 208-733-9463
Mailing address:
  • Phone: 208-734-3356
  • Fax: 208-733-9463

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

VIII. Authorized Official

Name: JAMES ANNEST
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 208-734-3356