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General NPI Number Information
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NPI Number | 1447017983
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Entity Type | Organization
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Legal Business Name | OSMS ANESTHESIA LLC
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 2223 LIME KILN RD STE 1
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City | GREEN BAY
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State | WI
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Zip | 54311-6213
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Country | US
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Telephone | 920-430-8113
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Fax |
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Provider Business Mailing Address
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Address Line | 2223 LIME KILN RD STE 1
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City | GREEN BAY
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State | WI
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Zip | 54311-6213
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Country | US
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Telephone | 920-430-8113
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | KATIE KLAUS
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Credential |
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Telephone | 920-965-9517
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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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