MEDICARE: PHYSICIAN SPECIALISTS IN ANESTHESIA, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	GA
2	367500000X	Certified Registered Nurse Anesthetist	GA
3	367H00000X	Anesthesiologist Assistant	GA
4	207L00000X	Anesthesiology Physician	GA

General Provider Information

NPI Number	:	1316968662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN SPECIALISTS IN ANESTHESIA, P.C.

Provider Business Mailing Address
First Line	:	5671 PEACHTREE DUNWOODY RD
Second Line	:	SUITE 610
City	:	ATLANTA
State	:	GA
Zip	:	30342-5000
Country	:	US
Telephone Number	:	404-257-1415
Fax Number	:	404-851-1649

Provider Business Practice Location Address
First Line	:	5665 PEACHTREE DUNWOODY RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1701
Country	:	US
Telephone Number	:	404-851-7324
Fax Number	:	404-843-2627

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MELONY LYNN EPPS
Credential	:
Telephone Number	:	404-257-8603

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	06/26/2018

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