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General NPI Number Information
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NPI Number | 1053451781
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Entity Type | Organization
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Legal Business Name | RIVER CITY ANESTHESIOLOGY PC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 1874 BELTLINE RD SW
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City | DECATUR
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State | AL
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Zip | 35601-5514
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Country | US
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Telephone | 256-301-3340
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1547
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City | SEDALIA
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State | MO
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Zip | 65302-1547
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Country | US
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Telephone | 660-826-5960
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Fax | 660-826-4852
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY MARKHAM
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Credential | MD
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Telephone | 256-301-3340
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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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