Basic Information
| Provider Information | |||||||||
| NPI: | 1871750612 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANTAGE ANESTHESIOLOGY P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8900 STATE LINE RD | ||||||||
| Address2: | #420 | ||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662061941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885330566 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8900 STATE LINE RD | ||||||||
| Address2: | #420 | ||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662061941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8885330566 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2008 | ||||||||
| LastUpdateDate: | 05/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | VARLOTTA | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8885330566 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.