Healthcare Provider Details
I. General information
NPI: 1225331978
Provider Name (Legal Business Name): SONNO ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/17/2010
Last Update Date: 12/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
804 22ND AVE
KEARNEY NE
68845-2206
US
IV. Provider business mailing address
6420 56TH AVE
KEARNEY NE
68845-0380
US
V. Phone/Fax
- Phone: 308-455-3600
- Fax:
- Phone: 308-224-2062
- Fax: 888-974-5962
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MERLIN
WEHLING
Title or Position: PRESIDENT
Credential: M.D.
Phone: 308-627-7528