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General NPI Number Information
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NPI Number | 1073531844
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN INDIANA ANESTHESIA ASSOCIATES PC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 3200 SYCAMORE CT STE 1B
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City | COLUMBUS
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State | IN
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Zip | 47203-1545
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Country | US
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Telephone | 812-378-9027
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Fax | 812-378-1014
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Provider Business Mailing Address
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Address Line | 3200 SYCAMORE CT STE B
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City | COLUMBUS
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State | IN
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Zip | 47203-1550
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Country | US
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Telephone | 812-378-9027
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Fax | 812-378-1014
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KRISTY MARTIN
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Credential |
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Telephone | 812-378-9027
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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 | 50003132A
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License Number State | IN
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