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General NPI Number Information
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NPI Number | 1578754263
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Entity Type | Organization
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Legal Business Name | ANESTHESIA CARE OF CORBIN PSC
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 1 TRILLIUM WAY
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City | CORBIN
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State | KY
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Zip | 40701-8426
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Country | US
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Telephone | 901-892-7161
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10484
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City | BIRMINGHAM
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State | AL
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Zip | 35202-0484
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Country | US
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Telephone | 205-322-1808
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Fax | 205-322-1851
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Authorized Official
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Title or Position | CFO
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Name | ALAN DALE HILLIARD
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Credential |
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Telephone | 205-322-1808
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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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