Healthcare Provider Details
I. General information
NPI: 1821042342
Provider Name (Legal Business Name): FALLS ANESTHESIA GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2006
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 23RD ST
CUYAHOGA FALLS OH
44223-1404
US
IV. Provider business mailing address
2106 ALBERTSON PKWY
CUYAHOGA FALLS OH
44223-2502
US
V. Phone/Fax
- Phone: 330-971-7000
- Fax: 330-296-6535
- Phone: 330-971-7000
- Fax: 330-296-6535
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARK
S
SMILEK
Title or Position: PRESIDENT
Credential: DO
Phone: 330-971-0401