Basic Information
| Provider Information | |||||||||
| NPI: | 1902231673 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHERN REGIONAL ANESTHESIOLOGY CONSULTANTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 S UNIVERSITY AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 S UNIVERSITY AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2013 | ||||||||
| LastUpdateDate: | 03/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | KERR | ||||||||
| AuthorizedOfficialFirstName: | TERI | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5016644532 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | E2798 | AR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.