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General NPI Number Information
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NPI Number | 1720101934
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Entity Type | Organization
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Legal Business Name | OFFICE ANESTHESIA SERVICE LLC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1730 GALLERIA OAKS DR
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City | TEXARKANA
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State | TX
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Zip | 75503-4649
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Country | US
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Telephone | 903-793-6780
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20451
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City | COLUMBUS
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State | OH
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Zip | 43220-0451
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Country | US
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Telephone | 614-451-7346
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Fax | 614-451-5846
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEVEN DUANE HILL
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Credential | CRNA
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Telephone | 501-328-7648
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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 | R31688
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License Number State | AR
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