Basic Information
| Provider Information | |||||||||
| NPI: | 1811167877 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREMIER ANESTHESIA CONSULTANTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 643863 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452643863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372976072 | ||||||||
| FaxNumber: | 5134205747 | ||||||||
| Practice Location | |||||||||
| Address1: | 5950 INNOVATION DRIVE | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450052584 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372976072 | ||||||||
| FaxNumber: | 5134205747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2008 | ||||||||
| LastUpdateDate: | 06/21/2017 | ||||||||
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| AuthorizedOfficialLastName: | WARE | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9372976072 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | OH | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | OH | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.