Healthcare Provider Details

I. General information

NPI: 1891210852
Provider Name (Legal Business Name): CAPSTONE ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GYPSY LANE
YOUNGSTOWN OH
44504
US

IV. Provider business mailing address

6406 CORRINE DR NW
CANTON OH
44718
US

V. Phone/Fax

Practice location:
  • Phone: 321-279-9157
  • Fax:
Mailing address:
  • Phone: 330-268-5648
  • Fax: 330-494-0676

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: DAVID SCOTT CURRIER
Title or Position: PRESIDENT
Credential: MD
Phone: 330-268-5648