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General NPI Number Information
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NPI Number | 1104003904
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Entity Type | Organization
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Legal Business Name | ANESTHESIA SERVICES OF INDIANA, LLC
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 13714 STONE DR
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City | CARMEL
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State | IN
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Zip | 46032-9409
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Country | US
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Telephone | 812-322-0708
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 68952
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-0952
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOE LAFNITZEGGER
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Credential | MD
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Telephone | 812-322-0708
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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 | 01051026A
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License Number State | IN
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