Healthcare Provider Details

I. General information

NPI: 1922059898
Provider Name (Legal Business Name): ANESTHESIA CONSULTANTS OF INDIANAPOLIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N SENATE BLVD
INDIANAPOLIS IN
46202-1228
US

IV. Provider business mailing address

4725 STATESMEN DRIVE SUITE C-D
INDIANAPOLIS IN
46250
US

V. Phone/Fax

Practice location:
  • Phone: 317-567-2179
  • Fax: 317-567-2191
Mailing address:
  • Phone: 317-577-4200
  • Fax: 317-577-9503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: ALEXANDER CHOI
Title or Position: PRESIDENT
Credential: MD
Phone: 317-577-4200