Healthcare Provider Details
I. General information
NPI: 1932156965
Provider Name (Legal Business Name): AMERICA'S ANESTHESIOLOGIST, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2006
Last Update Date: 09/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1726 SHAWANO AVE
GREEN BAY WI
54303-3216
US
IV. Provider business mailing address
225 S EXECUTIVE DR
BROOKFIELD WI
53005-4266
US
V. Phone/Fax
- Phone: 920-498-4200
- Fax:
- Phone: 262-787-4026
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RODNEY
H
SATHOFF
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 920-498-4200