Basic Information
| Provider Information | |||||||||
| NPI: | 1518242189 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIFOUR ANESTHESIA ASSOCIATES, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 415 N CENTER ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286015057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283278105 | ||||||||
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| Practice Location | |||||||||
| Address1: | 415 N CENTER ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286015057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283278105 | ||||||||
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| ProviderEnumerationDate: | 10/14/2011 | ||||||||
| LastUpdateDate: | 10/14/2011 | ||||||||
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| AuthorizedOfficialLastName: | REEVES | ||||||||
| AuthorizedOfficialFirstName: | GERRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8283278105 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.