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General NPI Number Information
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NPI Number | 1124496906
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Entity Type | Organization
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Legal Business Name | SOVA ANESTHESIA, PLLC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 2734 LIZZIE CV
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City | SOUTHAVEN
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State | MS
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Zip | 38671-7510
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Country | US
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Telephone | 901-831-0930
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Fax |
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Provider Business Mailing Address
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Address Line | 2734 LIZZIE CV
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City | SOUTHAVEN
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State | MS
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Zip | 38671-7510
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Country | US
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Telephone | 901-831-0930
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SARAH E HODGE
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Credential | CRNA
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Telephone | 901-831-0930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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