Healthcare Provider Details

I. General information

NPI: 1154349827
Provider Name (Legal Business Name): SOUTHERN INDIANA ANESTHESIA CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 STATE ST
NEW ALBANY IN
47150-4990
US

IV. Provider business mailing address

PO BOX 70101
LOUISVILLE KY
40270-0101
US

V. Phone/Fax

Practice location:
  • Phone: 502-690-8782
  • Fax: 502-459-0923
Mailing address:
  • Phone: 502-690-8782
  • Fax: 502-459-0923

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: DR. BARRY H MILLER
Title or Position: OWNER
Credential: M.D.
Phone: 502-690-8782