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General NPI Number Information
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NPI Number | 1275646598
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Entity Type | Organization
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Legal Business Name | CENTRALIA ANESTHESIOLOGY SERVICES LTD
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 400 N PLEASANT AVE
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City | CENTRALIA
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State | IL
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Zip | 62801-3056
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Country | US
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Telephone | 618-436-5521
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Fax | 618-436-8036
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Provider Business Mailing Address
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Address Line | 4227 LINCOLNSHIRE DR
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City | MOUNT VERNON
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State | IL
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Zip | 62864-2157
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Country | US
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Telephone | 618-242-2317
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Fax | 618-242-9710
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK M EATON
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Credential | MD
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Telephone | 618-241-1108
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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 | 42618797
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License Number State | IL
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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 | 42618797
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License Number State | IL
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