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General NPI Number Information
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NPI Number | 1407200744
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Entity Type | Organization
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Legal Business Name | ALL-AMERICAN ANESTHESIA LLC
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 3202 BOONE TRL
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2134
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Country | US
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Telephone | 855-888-3749
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Fax |
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Provider Business Mailing Address
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Address Line | 3202 BOONE TRL
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2134
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Country | US
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Telephone | 855-888-3749
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Fax |
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Authorized Official
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Title or Position | CREDENTIALER
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Name | NIKI JOHNSON
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Credential |
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Telephone | 855-888-3749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 47590
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License Number State | NC
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