Basic Information
| Provider Information | |||||||||
| NPI: | 1679157887 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANESTHESIA ASSOCIATES OF BAYOU REGION LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6014 | ||||||||
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| City: | HOUMA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703616014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9858734751 | ||||||||
| FaxNumber: | 9858733789 | ||||||||
| Practice Location | |||||||||
| Address1: | 402 DUNN ST | ||||||||
| Address2: | |||||||||
| City: | HOUMA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703604704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9858731661 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2021 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| AuthorizedOfficialLastName: | YEATES | ||||||||
| AuthorizedOfficialFirstName: | FRANCES | ||||||||
| AuthorizedOfficialMiddleName: | DIANE | ||||||||
| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 9858734751 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.