Provider Demographics
NPI:1427685247
Name:PRIME ANESTHESIA PLLC
Entity type:Organization
Organization Name:PRIME ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-845-0007
Mailing Address - Street 1:3118 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3644
Mailing Address - Country:US
Mailing Address - Phone:720-845-0007
Mailing Address - Fax:303-648-5800
Practice Address - Street 1:3118 NEWTON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3644
Practice Address - Country:US
Practice Address - Phone:720-845-0007
Practice Address - Fax:303-648-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-23
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty