Healthcare Provider Details

I. General information

NPI: 1104378553
Provider Name (Legal Business Name): ANESTHESIA SERVICES ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 03/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 RAWLS DR STE 1500
MCCOMB MS
39648-2878
US

IV. Provider business mailing address

PO BOX 440210
NASHVILLE TN
37244-0210
US

V. Phone/Fax

Practice location:
  • Phone: 601-680-4599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PETER KROLL
Title or Position: CEO
Credential: MD
Phone: 615-824-3737