Provider Demographics
NPI:1003387044
Name:ADVANCED ANESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCED ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:GRANSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:662-322-6616
Mailing Address - Street 1:106 HIGH FOREST DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-0401
Mailing Address - Country:US
Mailing Address - Phone:662-322-6616
Mailing Address - Fax:
Practice Address - Street 1:306 BRADLEY RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-7047
Practice Address - Country:US
Practice Address - Phone:662-286-9292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery