Basic Information
| Provider Information | |||||||||
| NPI: | 1699951947 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | B & C ANESTHESIA SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 W GREENLAWN AVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489102898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174822118 | ||||||||
| FaxNumber: | 5174826280 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 W GREENLAWN AVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489102898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174822118 | ||||||||
| FaxNumber: | 5174826280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2008 | ||||||||
| LastUpdateDate: | 01/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | BEZ | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5174822118 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.