Basic Information
| Provider Information | |||||||||
| NPI: | 1144645656 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INTEGRATED ANESTHESIA CONSULTANTS PLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5068 | ||||||||
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| City: | SUN CITY WEST | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853765068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6237774747 | ||||||||
| FaxNumber: | 6237774748 | ||||||||
| Practice Location | |||||||||
| Address1: | 3615 S ROME ST | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852977335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6237774747 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2014 | ||||||||
| LastUpdateDate: | 01/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | TOM | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6237774747 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.