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General NPI Number Information
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NPI Number | 1467296871
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Entity Type | Organization
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Legal Business Name | WEST PACES ANESTHESIA SERVICES, LLC
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 3200 DOWNWOOD CIR NW STE 400
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City | ATLANTA
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State | GA
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Zip | 30327-1624
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Country | US
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Telephone | 404-390-3294
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Fax | 404-390-3212
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Provider Business Mailing Address
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Address Line | 3200 DOWNWOOD CIR NW STE 400
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City | ATLANTA
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State | GA
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Zip | 30327-1624
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Country | US
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Telephone | 404-390-3294
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Fax | 404-390-3212
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MIRIAM REBEKAH VAIL
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Credential | RN
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Telephone | 404-390-3294
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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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