Healthcare Provider Details

I. General information

NPI: 1518872696
Provider Name (Legal Business Name): ATLAS ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 MAIN ST
STEVENS POINT WI
54481-2864
US

IV. Provider business mailing address

1257 MAIN ST
STEVENS POINT WI
54481-2864
US

V. Phone/Fax

Practice location:
  • Phone: 262-573-9095
  • Fax:
Mailing address:
  • Phone: 262-573-9095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CONDADO
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 715-499-6858