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NPI Code Detail

MEDICARE: THE CAPITAL CITY ANESTHESIA GROUP

MEDICARE: THE CAPITAL CITY ANESTHESIA GROUP
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
1174400000XSpecialist
2367500000XCertified Registered Nurse Anesthetist
3207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1245282466
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CAPITAL CITY ANESTHESIA GROUP
Provider Business Mailing Address
First Line : 744 W MICHIGAN AVE
Second Line :
City : JACKSON
State : MI
Zip : 49201-1909
Country : US
Telephone Number : 800-242-1131
Fax Number : 517-787-4146
Provider Business Practice Location Address
First Line : 8585 PICARDY AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3748
Country : US
Telephone Number : 504-388-3314
Fax Number : 781-407-7712
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : BAIN MANNING
Credential :
Telephone Number : 504-388-3314
Provider Enumeration Date : 05/16/2006
Last Update Date : 10/05/2022

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Directions to “THE CAPITAL CITY ANESTHESIA GROUP ” Practice Location

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