Provider Demographics
NPI:1184687881
Name:ANESTHESIOLOGY SERVICES LTD
Entity Type:Organization
Organization Name:ANESTHESIOLOGY SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FOR CORPORATE COMPLIANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACYE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ENIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-771-4693
Mailing Address - Street 1:PO BOX 190670
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72219-0670
Mailing Address - Country:US
Mailing Address - Phone:501-771-4693
Mailing Address - Fax:501-771-4885
Practice Address - Street 1:3333 SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2922
Practice Address - Country:US
Practice Address - Phone:501-202-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105237002Medicaid
AR105237002Medicaid