Provider Demographics
NPI:1972291235
Name:TUCSON AMBULATORY ANESTHESIA LLC
Entity type:Organization
Organization Name:TUCSON AMBULATORY ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRITSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-314-6079
Mailing Address - Street 1:5240 E KNIGHT DR STE 104
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2122
Mailing Address - Country:US
Mailing Address - Phone:520-888-6600
Mailing Address - Fax:
Practice Address - Street 1:2424 N WYATT DR STE 160
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6119
Practice Address - Country:US
Practice Address - Phone:520-815-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty