Healthcare Provider Details

I. General information

NPI: 1194025544
Provider Name (Legal Business Name): ANESTHESIA BILLING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5355 COMMERCE DR
CROWN POINT IN
46307-5325
US

IV. Provider business mailing address

5355 COMMERCE DR
CROWN POINT IN
46307-5325
US

V. Phone/Fax

Practice location:
  • Phone: 219-756-0600
  • Fax: 219-756-0608
Mailing address:
  • Phone: 219-756-0600
  • Fax: 219-756-0608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY R YESSENOW
Title or Position: MANAGER
Credential: M.D.
Phone: 219-756-0600