MEDICARE: ANESTHESIOLOGY SERVICES NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225159056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIOLOGY SERVICES NETWORK

Provider Business Mailing Address
First Line	:	1 WYOMING ST
Second Line	:	3RD FLR SURGICAL SERVICES
City	:	DAYTON
State	:	OH
Zip	:	45409-2722
Country	:	US
Telephone Number	:	937-208-4380
Fax Number	:	937-208-3843

Provider Business Practice Location Address
First Line	:	2400 MIAMI VALLEY DR
Second Line	:	SUITE 2000
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-4774
Country	:	US
Telephone Number	:	937-208-4380
Fax Number	:	937-208-3843

Authorized Official
Title or Position	:	CEO
Name	:	JAMIE KREITZER
Credential	:
Telephone Number	:	937-208-4380

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	09/18/2009

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Directions to “ANESTHESIOLOGY SERVICES NETWORK ” Practice Location

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