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General NPI Number Information
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NPI Number | 1134677396
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Entity Type | Organization
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Legal Business Name | ANESTHESIA SERVICES ASSOCIATES PLLC
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 500 PINEVIEW DR STE 205
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City | KERNERSVILLE
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State | NC
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Zip | 27284-3812
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Country | US
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Telephone | 336-310-6115
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 440210
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City | NASHVILLE
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State | TN
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Zip | 37244-0210
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Country | US
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Telephone | 336-842-8339
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MANDY ROBERTSON
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Credential |
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Telephone | 336-842-8339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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