MEDICARE: ANESTHESIA SERVICES OF ALBUQUERQUE

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	89-28	NM

General Provider Information

NPI Number	:	1427490424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIA SERVICES OF ALBUQUERQUE

Provider Business Mailing Address
First Line	:	PO BOX 670382
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-0382
Country	:	US
Telephone Number	:	503-372-2740
Fax Number	:

Provider Business Practice Location Address
First Line	:	9551 PASEO DEL NORTE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87122-2975
Country	:	US
Telephone Number	:	505-639-4640
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEVIN T DIXON
Credential	:	MD
Telephone Number	:	505-299-2350

Provider Enumeration Date	:	07/19/2013
Last Update Date	:	07/19/2013

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Directions to “ANESTHESIA SERVICES OF ALBUQUERQUE ” Practice Location

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