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General NPI Number Information
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NPI Number | 1740252022
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Entity Type | Organization
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Legal Business Name | TMC-WEST GEORGIA ANESTHESIA ASSOCIATES INC.
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 705 DIXIE ST
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City | CARROLLTON
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State | GA
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Zip | 30117-3818
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Country | US
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Telephone | 334-279-1450
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Fax | 334-279-1660
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Provider Business Mailing Address
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Address Line | PO BOX 235019
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City | MONTGOMERY
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State | AL
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Zip | 36123-5019
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Country | US
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Telephone | 334-279-1450
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Fax | 334-279-1660
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | JILL RAGSDALE
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Credential |
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Telephone | 334-279-1450
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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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Taxonomy #2
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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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