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General NPI Number Information
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NPI Number | 1487107157
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Entity Type | Organization
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Legal Business Name | AMS SOUTHEAST LLC
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Dates
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Enumeration Date | 07/29/2016
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 28 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32502-5626
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Country | US
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Telephone | 866-653-2540
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Fax | 941-358-9818
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Provider Business Mailing Address
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Address Line | PO BOX 3184
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City | SPRINGFIELD
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State | IL
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Zip | 62708-3184
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Country | US
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Telephone | 941-360-1566
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Fax | 941-358-9818
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Authorized Official
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Title or Position | MEMBER
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Name | DAVID W. SIMPSON
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Credential | MD
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Telephone | 941-961-8697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | GA
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Taxonomy #2
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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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Taxonomy #3
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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 | GA
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