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General NPI Number Information
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NPI Number | 1164748935
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Entity Type | Organization
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Legal Business Name | NORTHEAST GEORGIA ANESTHESIOLOGY LLC
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 3320 OLD JEFFERSON RD
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City | ATHENS
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State | GA
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Zip | 30607-1400
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Country | US
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Telephone | 706-623-4271
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Fax | 706-225-7217
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Provider Business Mailing Address
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Address Line | 3414 PEACHTREE RD NE STE 340
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City | ATLANTA
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State | GA
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Zip | 30326-1137
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Country | US
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Telephone | 425-803-3885
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Fax |
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Authorized Official
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Title or Position | VP OF REVENUE CYCLE
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Name | JEFF L PERRY
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Credential |
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Telephone | 502-418-4700
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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 |
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License Number State |
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Taxonomy #2
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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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