Healthcare Provider Details
I. General information
NPI: 1376502294
Provider Name (Legal Business Name): SOUTH CENTRAL ANESTHESIA LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2006
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1300 E 5TH AVE
WINFIELD KS
67156-2407
US
IV. Provider business mailing address
PO BOX 15
WINFIELD KS
67156-0015
US
V. Phone/Fax
- Phone: 620-221-2300
- Fax: 620-221-9560
- Phone: 316-281-3700
- Fax: 866-835-2232
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
STEVEN
D
NEWSOME
Title or Position: PARTNER
Credential: CRNA
Phone: 620-441-3881