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General NPI Number Information
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NPI Number | 1689327322
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Entity Type | Organization
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Legal Business Name | AT YOUR SERVICE ANESTHESIA AND THERAPEUTICS, LLC
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 01/14/2023
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Provider Practice Location Address
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Address Line | 1785 E PARK PLACE BLVD STE 212
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3458
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Country | US
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Telephone | 470-395-6076
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Fax | 470-745-0716
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Provider Business Mailing Address
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Address Line | PO BOX 870822
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-0021
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Country | US
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Telephone | 470-395-6076
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Fax | 470-745-0716
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Authorized Official
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Title or Position | CEO /PRESIDENT
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Name | DR. SELWYNN BRYAN HOWARD
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Credential | MD
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Telephone | 470-395-6076
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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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