Provider Demographics
NPI:1043242100
Name:ORO VALLEY ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:ORO VALLEY ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-529-0313
Mailing Address - Street 1:ORO VALLEY ANESTHESIA PLLC
Mailing Address - Street 2:DEPARTMENT 9538
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90084-9538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12995 N ORACLE RD
Practice Address - Street 2:SUITE 141 BOX 411
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9528
Practice Address - Country:US
Practice Address - Phone:520-529-0313
Practice Address - Fax:520-901-3642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ100735Medicare PIN