Basic Information
| Provider Information | |||||||||
| NPI: | 1518912666 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEPHENS COUNTY ANESTHESIA SERVICES,LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 452 CROSS CREEK DR | ||||||||
| Address2: | |||||||||
| City: | TOCCOA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305772781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062977749 | ||||||||
| FaxNumber: | 7062977749 | ||||||||
| Practice Location | |||||||||
| Address1: | 163 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | TOCCOA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305776820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062824200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 09/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | EASLEY | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | EDMUNDS | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7062977749 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NR1301X | 024670 | GA | Y | Hospitals | General Acute Care Hospital | Rural |
No ID Information.