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General NPI Number Information
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NPI Number | 1376952887
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Entity Type | Organization
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Legal Business Name | HENRY ANESTHESIA ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 1740 HUDSON BRIDGE RD SUITE 1218
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6331
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Country | US
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Telephone | 678-604-1053
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 HUDSON BRIDGE RD SUITE 1218
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. LEE GARNER
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Credential |
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Telephone | 678-604-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State |
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