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General NPI Number Information
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NPI Number | 1720855083
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Entity Type | Organization
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Legal Business Name | MOBILE ANESTHESIA PROVIDERS
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1254 W UNIVERSITY AVE STE 130
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-7217
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Country | US
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Telephone | 800-407-1744
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Fax |
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Provider Business Mailing Address
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Address Line | 1254 W UNIVERSITY AVE STE 130
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-7217
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | N/A
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Name | KIMBERLY GEIS
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Credential |
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Telephone | 800-407-1744
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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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