Provider Demographics
NPI:1205012150
Name:SCL ANESTHESIA PLLC
Entity Type:Organization
Organization Name:SCL ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LADSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:734-208-7128
Mailing Address - Street 1:13305 REECK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-3054
Mailing Address - Country:US
Mailing Address - Phone:734-246-9600
Mailing Address - Fax:
Practice Address - Street 1:14050 DIX TOLEDO RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2501
Practice Address - Country:US
Practice Address - Phone:734-281-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty