Healthcare Provider Details

I. General information

NPI: 1043247562
Provider Name (Legal Business Name): ANESTHESIOLOGY ASSOCIATES OF GLASGOW, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 05/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N RACE ST
GLASGOW KY
42141-3454
US

IV. Provider business mailing address

PO BOX 1947
GLASGOW KY
42142-1947
US

V. Phone/Fax

Practice location:
  • Phone: 270-651-8338
  • Fax: 270-651-3243
Mailing address:
  • Phone: 270-651-8338
  • Fax: 270-651-3243

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. MURALIDHAR SANTAPURAM
Title or Position: OWNER
Credential: MD
Phone: 270-651-8338