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General NPI Number Information
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NPI Number | 1861913865
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANESTHESIA SOLUTIONS, INC
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/29/2017
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Provider Practice Location Address
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Address Line | 2880 OLD ALABAMA RD
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City | ALPHARETTA
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State | GA
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Zip | 30022-5031
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Country | US
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Telephone | 404-205-1889
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Fax |
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Provider Business Mailing Address
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Address Line | 600 PHIPPS BLVD NE APT 2512
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City | ATLANTA
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State | GA
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Zip | 30326-3374
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Country | US
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Telephone | 404-205-1889
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STAR ROGERS
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Credential | MD
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Telephone | 404-205-1889
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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 | 73636
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License Number State | GA
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