Healthcare Provider Details

I. General information

NPI: 1821076779
Provider Name (Legal Business Name): ANESTHESIOLOGY SERVICES NETWORK LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST.
DAYTON OH
45409
US

IV. Provider business mailing address

1 WYOMING ST. ANESTHESIA DEPT
DAYTON OH
45409
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-4380
  • Fax: 937-208-3843
Mailing address:
  • Phone: 937-208-4380
  • Fax: 937-208-3843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMIE L. KREITZER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 937-208-4380