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General NPI Number Information
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NPI Number | 1174950984
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Entity Type | Organization
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Legal Business Name | PRECISION ANESTHESIA SERVICES, LLC
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Dates
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Enumeration Date | 10/11/2013
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 68 STATE ROUTE 7
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City | BRIDGEPORT
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State | OH
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Zip | 43912-1642
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Country | US
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Telephone | 740-994-0900
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Fax | 740-609-3036
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Provider Business Mailing Address
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Address Line | 66325 PLAINFIELD RD
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City | BELMONT
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State | OH
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Zip | 43718-9775
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Country | US
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Telephone | 740-310-6743
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY E PORTER
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Credential | CRNA
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Telephone | 740-310-6743
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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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