Healthcare Provider Details

I. General information

NPI: 1407922271
Provider Name (Legal Business Name): NORTHWOODS ANESTHESIA SERVICES, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2006
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 N SHORE DR
RHINELANDER WI
54501-8360
US

IV. Provider business mailing address

2251 N SHORE DR
RHINELANDER WI
54501-8360
US

V. Phone/Fax

Practice location:
  • Phone: 715-361-2113
  • Fax:
Mailing address:
  • Phone: 715-361-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GURKIPAL S SIKKA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 715-361-2113