1679882039 NPI number — EIRING ANESTHESIA ASSOCIATES, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679882039 NPI number — EIRING ANESTHESIA ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EIRING ANESTHESIA ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EIRING ANESTHESIA ASSOCIATES,P.C.
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679882039
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 PLEASANT HOME RD STE 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30907-0518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-364-4171
Provider Business Mailing Address Fax Number:
706-364-4171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3658 J DEWEY GRAY CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30909-6424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-651-2020
Provider Business Practice Location Address Fax Number:
706-364-4171
Provider Enumeration Date:
10/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DORR
Authorized Official First Name:
TRACY
Authorized Official Middle Name:
K
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
706-364-4171

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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