Basic Information
| Provider Information | |||||||||
| NPI: | 1851343487 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANESTHESIA PHYSICIANS LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5126 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571175126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053351952 | ||||||||
| FaxNumber: | 6053739971 | ||||||||
| Practice Location | |||||||||
| Address1: | 1305 W 18TH ST | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571050401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053385488 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 04/05/2021 | ||||||||
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| AuthorizedOfficialLastName: | HOLIFIELD | ||||||||
| AuthorizedOfficialFirstName: | MARSHALL | ||||||||
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| AuthorizedOfficialTitleorPosition: | HEAD OF GROUP | ||||||||
| AuthorizedOfficialTelephone: | 6059511112 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 04/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 0140 | SD | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0570903 | 05 | IA | MEDICAID | 1632804-01 | 05 | TX | MEDICAID | 18912 | 05 | ND | MEDICAID | 91164AN | 01 | MN | BCBS - GROUP | OTHER | 980812400 | 05 | MN | MEDICAID | 0002404 | 01 | SD | BCBS - GROUP | OTHER | 150722002 | 05 | AR | MEDICAID | 000544 | 05 | OR | MEDICAID |