MEDICARE: GUARDIAN ANESTHESIA SERVICES, INC

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

General Provider Information

NPI Number	:	1407450802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN ANESTHESIA SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 960556
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73196-0556
Country	:	US
Telephone Number	:	303-422-9438
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 E HARVARD AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-5824
Country	:	US
Telephone Number	:	303-778-5773
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTHONY KEEVER
Credential	:	MD
Telephone Number	:	303-524-5187

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	11/25/2020

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