Provider Demographics
NPI:1073982765
Name:ANESTHESIA SERVICES ASSOCIATES PLLC
Entity Type:Organization
Organization Name:ANESTHESIA SERVICES ASSOCIATES PLLC
Other - Org Name:COMPREHENSIVE PAIN SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:REID
Authorized Official - Last Name:DICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-824-3737
Mailing Address - Street 1:555 N NEW BALLAS RD
Mailing Address - Street 2:STE. 165
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6825
Mailing Address - Country:US
Mailing Address - Phone:314-942-7333
Mailing Address - Fax:314-764-2227
Practice Address - Street 1:555 N NEW BALLAS RD
Practice Address - Street 2:STE. 165
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6825
Practice Address - Country:US
Practice Address - Phone:314-942-7333
Practice Address - Fax:314-764-2227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANESTHESIA SERVICES ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X
IL207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty