Provider Demographics
NPI:1386334852
Name:OCOTILLO ANESTHESIA PLLC
Entity type:Organization
Organization Name:OCOTILLO ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHAGIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-550-4288
Mailing Address - Street 1:5670 W DUBLIN LN
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-6827
Mailing Address - Country:US
Mailing Address - Phone:602-550-4288
Mailing Address - Fax:
Practice Address - Street 1:5670 W DUBLIN LN
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-6827
Practice Address - Country:US
Practice Address - Phone:602-550-4288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty