MEDICARE: ONYX ANESTHESIA MANAGEMENT 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

General Provider Information

NPI Number	:	1609324946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONYX ANESTHESIA MANAGEMENT LLC.

Provider Business Mailing Address
First Line	:	PO BOX 112
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47308-0112
Country	:	US
Telephone Number	:	765-284-0493
Fax Number	:

Provider Business Practice Location Address
First Line	:	11625 CUSTER RD
Second Line	:	SUITE 110-154
City	:	FRISCO
State	:	TX
Zip	:	75035-8783
Country	:	US
Telephone Number	:	214-629-3576
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	BOBBY SMITH
Credential	:
Telephone Number	:	214-629-3576

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	09/15/2016

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