MEDICARE: INTEGRITY ANESTHESIA P.C.

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	174400000X	Specialist	035327	GA

General Provider Information

NPI Number	:	1891864658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY ANESTHESIA P.C.

Provider Business Mailing Address
First Line	:	PO BOX 1565
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533-0027
Country	:	US
Telephone Number	:	706-867-4116
Fax Number	:	706-867-4120

Provider Business Practice Location Address
First Line	:	227 MOUNTAIN DRIVE
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533-1614
Country	:	US
Telephone Number	:	706-867-4116
Fax Number	:	706-867-4120

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. KIM DOREEN GABLE
Credential	:
Telephone Number	:	706-867-4116

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	03/29/2010

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