Healthcare Provider Details

I. General information

NPI: 1902806789
Provider Name (Legal Business Name): CHILLICOTHE ANESTHESIA ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 HOSPITAL RD
CHILLICOTHEE OH
45601-9031
US

IV. Provider business mailing address

200 NORTHLAND BLVD FL 1
CINCINNATI OH
45246-3604
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-7540
  • Fax: 740-779-7867
Mailing address:
  • Phone: 513-672-4128
  • Fax: 513-672-4479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: RICHARD SORENSEN
Title or Position: PRESIDENT
Credential: MD
Phone: 740-779-7540