MEDICARE: ATLAS ANESTHESIA, 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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1841054814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS ANESTHESIA, LLC

Provider Business Mailing Address
First Line	:	3189 NW FAIRWAY HEIGHTS DR
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-8350
Country	:	US
Telephone Number	:	541-325-6813
Fax Number	:

Provider Business Practice Location Address
First Line	:	3189 NW FAIRWAY HEIGHTS DR
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-8350
Country	:	US
Telephone Number	:	541-325-6813
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD HANSON
Credential	:	MD
Telephone Number	:	541-325-6813

Provider Enumeration Date	:	02/09/2024
Last Update Date	:	02/09/2024

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Directions to “ATLAS ANESTHESIA, LLC ” Practice Location

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