Healthcare Provider Details

I. General information

NPI: 1538148754
Provider Name (Legal Business Name): BURLINGTON ANESTHESIA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 HUFFMAN MILL RD
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

PO BOX 1832
BURLINGTON NC
27216-1832
US

V. Phone/Fax

Practice location:
  • Phone: 336-585-1770
  • Fax: 336-585-1771
Mailing address:
  • Phone: 706-860-2701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. PAUL J CARROLL
Title or Position: PRES
Credential: MD
Phone: 336-585-1770