MEDICARE: COLUMBUS ANESTHESIA PC

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	50001451A	IN

General Provider Information

NPI Number	:	1497856801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS ANESTHESIA PC

Provider Business Mailing Address
First Line	:	4401 S 650 W
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-1548
Country	:	US
Telephone Number	:	812-342-1050
Fax Number	:	812-342-9620

Provider Business Practice Location Address
First Line	:	4401 S 650 W
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-1548
Country	:	US
Telephone Number	:	812-342-1050
Fax Number	:	812-342-9620

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT C JEFFREY
Credential	:	MD
Telephone Number	:	812-342-1050

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	08/22/2020

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