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General NPI Number Information
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NPI Number | 1588930028
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Entity Type | Organization
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Legal Business Name | AA ANESTHESIA
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 5400 LAUREL SPRINGS PKWY SUITE 1404
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City | SUWANEE
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State | GA
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Zip | 30024-6056
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Country | US
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Telephone | 770-331-3171
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Fax | 706-335-2257
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Provider Business Mailing Address
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Address Line | 315 SIMS BRIDGE RD
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City | COMMERCE
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State | GA
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Zip | 30530-6868
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Country | US
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Telephone | 770-331-3171
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Fax | 706-335-2257
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALVIS T PERRY
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Credential | M.D.
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Telephone | 770-331-3171
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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 | 034921
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License Number State | GA
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