Provider Demographics
NPI:1336718063
Name:GREATER WASHINGTON ANESTHESIA ASSOCIATES, LLC
Entity type:Organization
Organization Name:GREATER WASHINGTON ANESTHESIA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-418-4700
Mailing Address - Street 1:PO BOX 731002
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1002
Mailing Address - Country:US
Mailing Address - Phone:800-242-5080
Mailing Address - Fax:727-900-7770
Practice Address - Street 1:7915 LAKE MANASSAS DR STE 302
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3260
Practice Address - Country:US
Practice Address - Phone:571-248-0653
Practice Address - Fax:866-665-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty