Healthcare Provider Details

I. General information

NPI: 1275563108
Provider Name (Legal Business Name): GUARDIAN ANESTHESIA SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27327 DRIFTWOOD RD
FOLSOM LA
70437-7933
US

IV. Provider business mailing address

27327 DRIFTWOOD RD
FOLSOM LA
70437-7933
US

V. Phone/Fax

Practice location:
  • Phone: 985-796-5428
  • Fax: 985-871-9738
Mailing address:
  • Phone: 985-796-5428
  • Fax: 985-871-9738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. HAL D LAMB
Title or Position: OWNER
Credential: CRNA
Phone: 985-796-5428