MEDICARE: SOUTHWEST OHIO ANESTHESIA CONSULTANTS LLC

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	367500000X	Certified Registered Nurse Anesthetist
2	207L00000X	Anesthesiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000011498	OTHER	ANTHEM BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588645188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST OHIO ANESTHESIA CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	6225 N STATE HIGHWAY 161 STE 200
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-2241
Country	:	US
Telephone Number	:	214-687-0497
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 STATE RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45255-2439
Country	:	US
Telephone Number	:	800-930-6313
Fax Number	:	817-856-0655

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRIAN WOODS
Credential	:	MD
Telephone Number	:	214-577-2709

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	05/31/2022

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Directions to “SOUTHWEST OHIO ANESTHESIA CONSULTANTS LLC ” Practice Location

Language	Start Address	Practice Location

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