Basic Information
| Provider Information | |||||||||
| NPI: | 1992750640 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANPETE ANESTHESIA SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 491 | ||||||||
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| City: | EPHRAIM | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846270491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4354620315 | ||||||||
| FaxNumber: | 4354620315 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 S MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | MT PLEASANT | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846472222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4354622441 | ||||||||
| FaxNumber: | 4354622609 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2006 | ||||||||
| LastUpdateDate: | 10/11/2007 | ||||||||
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| AuthorizedOfficialLastName: | MEEK | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
| AuthorizedOfficialMiddleName: | HOUSTON | ||||||||
| AuthorizedOfficialTitleorPosition: | CRNA PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4354620315 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.