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General NPI Number Information
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NPI Number | 1619087319
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Entity Type | Organization
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Legal Business Name | SOUTHEAST ANESTHESIA ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/26/2016
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Provider Practice Location Address
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Address Line | 7191 CAHABA VALLEY RD SUITE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35242-6402
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Country | US
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Telephone | 205-408-9787
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Fax | 205-408-3993
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Provider Business Mailing Address
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Address Line | PO BOX 660257
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City | BIRMINGHAM
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State | AL
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Zip | 35266-0257
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Country | US
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Telephone | 205-979-5882
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Fax | 205-979-1248
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Authorized Official
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Title or Position | CO-OWNER
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Name | JASON WILLIAM COMBS
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Credential | CRNA
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Telephone | 205-213-8420
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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 |
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