Healthcare Provider Details
I. General information
NPI: 1346249422
Provider Name (Legal Business Name): EAU CLAIRE ANESTHESIOLOGISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1221 WHIPPLE ST
EAU CLAIRE WI
54703-5270
US
IV. Provider business mailing address
2107 HEIGHTS DR
EAU CLAIRE WI
54701-6130
US
V. Phone/Fax
- Phone: 715-839-3311
- Fax:
- Phone: 715-834-8721
- Fax: 715-834-3087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | WI |
VIII. Authorized Official
Name: MR.
STEVEN
M
KAPLA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 715-834-8721