Provider Demographics
NPI:1225811623
Name:BROOKWOOD ANESTHESIA INC
Entity Type:Organization
Organization Name:BROOKWOOD ANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-523-2381
Mailing Address - Street 1:76 BROOKWOOD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4312
Mailing Address - Country:US
Mailing Address - Phone:707-523-4907
Mailing Address - Fax:707-523-4953
Practice Address - Street 1:76 BROOKWOOD AVE STE B
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4312
Practice Address - Country:US
Practice Address - Phone:707-523-4907
Practice Address - Fax:707-523-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty