Provider Demographics
NPI:1164081519
Name:SOUTHERN ANESTHESIA SERVICES
Entity Type:Organization
Organization Name:SOUTHERN ANESTHESIA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-995-9967
Mailing Address - Street 1:7500 HUGH DANIEL DR STE 360
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7144
Mailing Address - Country:US
Mailing Address - Phone:205-995-9967
Mailing Address - Fax:
Practice Address - Street 1:7500 HUGH DANIEL DR STE 360
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7144
Practice Address - Country:US
Practice Address - Phone:205-995-9967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty