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General NPI Number Information
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NPI Number | 1588425649
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Entity Type | Organization
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Legal Business Name | ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 4586 TIMBER RIDGE DR STE 141
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-7517
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Country | US
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Telephone | 678-813-2741
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Fax |
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Provider Business Mailing Address
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Address Line | 2713 CHARLES HARDY PKWY STE 212
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City | DALLAS
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State | GA
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Zip | 30157-9445
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Country | US
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Telephone | 678-528-5567
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANATHA KAMATH
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Credential | MD
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Telephone | 678-813-2741
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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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