Basic Information
| Provider Information | |||||||||
| NPI: | 1689829400 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AHP OF WESTERN LOUISANA, LLC | ||||||||
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| OtherOrganizationName: | ANESTHESIA HEALTHCARE PARTNERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 PACES FERRY RD SE | ||||||||
| Address2: | BUILDING II, STE 400 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303394053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6782237797 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2105 AIRLINE DR | ||||||||
| Address2: | |||||||||
| City: | BOSSIER CITY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711113105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185492011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2008 | ||||||||
| LastUpdateDate: | 11/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | HITE | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6782237797 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.