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General NPI Number Information
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NPI Number | 1477927531
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Entity Type | Organization
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Legal Business Name | BRECKSVILLE ANESTHESIA, LLC
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 7001 S EDGERTON RD STE A
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City | BRECKSVILLE
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State | OH
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Zip | 44141-4206
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Country | US
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Telephone | 440-717-0491
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Fax | 440-717-0594
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Provider Business Mailing Address
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Address Line | 7001 S EDGERTON RD STE A
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City | BRECKSVILLE
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State | OH
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Zip | 44141-4206
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Country | US
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Telephone | 440-717-0491
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Fax | 440-717-0594
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM WILEY
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Credential | M.D.
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Telephone | 440-840-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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