Basic Information
| Provider Information | |||||||||
| NPI: | 1770024390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PINNACLE ANESTHESIA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11414 LAKE SHERWOOD AVE N | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708160406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257549478 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11414 LAKE SHERWOOD AVE N | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257549478 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2017 | ||||||||
| LastUpdateDate: | 08/30/2018 | ||||||||
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| AuthorizedOfficialLastName: | SHEFFIELD | ||||||||
| AuthorizedOfficialFirstName: | LESLIE | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 2257681611 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.