Provider Demographics
NPI:1316093305
Name:ARES ANESTHESIOLOGY, PC
Entity type:Organization
Organization Name:ARES ANESTHESIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RAUL
Authorized Official - Last Name:ARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-230-1451
Mailing Address - Street 1:101 CIVIC CENTER LN
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5607
Mailing Address - Country:US
Mailing Address - Phone:928-230-1451
Mailing Address - Fax:928-855-7337
Practice Address - Street 1:101 CIVIC CENTER LN
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5607
Practice Address - Country:US
Practice Address - Phone:928-230-1451
Practice Address - Fax:928-855-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ30822207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00022339OtherRR MC
AZAZ0733520OtherBCBS
AZ776700Medicaid
ASH83896Medicare UPIN
AZ75648Medicare ID - Type UnspecifiedGROUP ID