Provider Demographics
NPI:1932572864
Name:EXCEL ANESTHESIA
Entity type:Organization
Organization Name:EXCEL ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-623-6699
Mailing Address - Street 1:1090 EXPERIMENT STATION RD
Mailing Address - Street 2:#529
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-5305
Mailing Address - Country:US
Mailing Address - Phone:706-623-6699
Mailing Address - Fax:706-850-7733
Practice Address - Street 1:100 RICE MINE RD
Practice Address - Street 2:STE E
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2375
Practice Address - Country:US
Practice Address - Phone:706-623-6699
Practice Address - Fax:706-850-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty