Healthcare Provider Details

I. General information

NPI: 1265650949
Provider Name (Legal Business Name): SOUTHWOODS ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7630 SOUTHERN BLVD
YOUNGSTOWN OH
44512-5633
US

IV. Provider business mailing address

7630 SOUTHERN BLVD
YOUNGSTOWN OH
44512-5633
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-8000
  • Fax: 330-729-8088
Mailing address:
  • Phone: 330-729-8000
  • Fax: 330-729-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWARD W MURANSKY
Title or Position: CEO
Credential:
Phone: 330-729-8000