Provider Demographics
NPI:1306083498
Name:APPALACHIAN ANESTHESIA AND ANALGESIA SERVICES PLLC
Entity type:Organization
Organization Name:APPALACHIAN ANESTHESIA AND ANALGESIA SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RASUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-305-6353
Mailing Address - Street 1:100 JOHN SUTHERLAND DR
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2424
Mailing Address - Country:US
Mailing Address - Phone:859-305-6353
Mailing Address - Fax:859-305-6443
Practice Address - Street 1:100 JOHN SUTHERLAND DR
Practice Address - Street 2:SUITE 6A
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2424
Practice Address - Country:US
Practice Address - Phone:859-305-6353
Practice Address - Fax:859-305-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37590207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00928Medicare PIN