Provider Demographics
NPI:1588425649
Name:ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-813-2741
Mailing Address - Street 1:2713 CHARLES HARDY PKWY STE 212
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-9445
Mailing Address - Country:US
Mailing Address - Phone:678-528-5567
Mailing Address - Fax:
Practice Address - Street 1:4586 TIMBER RIDGE DR STE 141
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7517
Practice Address - Country:US
Practice Address - Phone:678-813-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty