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General NPI Number Information
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NPI Number | 1053474122
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Entity Type | Organization
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Legal Business Name | LAWRENCE COUNTY ANESTHESIA ASSOC PC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 103 TECHNOLOGY DR
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City | BUTLER
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State | PA
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Zip | 16001-1785
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Country | US
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Telephone | 724-431-0609
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Fax | 724-431-0611
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Provider Business Mailing Address
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Address Line | 171 OMNI ST
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City | FOMBELL
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State | PA
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Zip | 16123-2109
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Country | US
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Telephone | 724-752-5230
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Fax | 724-431-0611
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOSEPH NOUR
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Credential | M.D.
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Telephone | 724-431-0609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD051352L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD051358L
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License Number State | PA
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