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General NPI Number Information
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NPI Number | 1043281553
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Entity Type | Organization
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Legal Business Name | MONTGOMERY ANESTHESIA ASSOCIATES, PC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1725 PINE ST
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City | MONTGOMERY
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State | AL
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Zip | 36106-1109
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Country | US
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Telephone | 334-293-8059
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 106090
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City | ATLANTA
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State | GA
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Zip | 30348-6090
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Country | US
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Telephone | 334-513-1173
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Fax | 855-999-1345
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY DOLES
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Credential | MD
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Telephone | 334-293-8008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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