Healthcare Provider Details

I. General information

NPI: 1164859013
Provider Name (Legal Business Name): ANESTHESIA & INTENSIVE CARE CONSULTANTS,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2013
Last Update Date: 10/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HOSPITAL DR
BATAVIA OH
45103-1921
US

IV. Provider business mailing address

20 MEDICAL VILLAGE DR STE 258
EDGEWOOD KY
41017-5411
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-7246
  • Fax: 859-341-7867
Mailing address:
  • Phone: 859-341-7246
  • Fax: 859-341-7867

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: LEE STEPHEN MEGOIS
Title or Position: PRESIDENT
Credential: MD
Phone: 859-341-7246