Provider Demographics
NPI:1235250846
Name:HCC ANESTHESIA SERVICES, LLC
Entity Type:Organization
Organization Name:HCC ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PORTIA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-257-0611
Mailing Address - Street 1:218 SANDY SPRINGS PL NE
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3812
Mailing Address - Country:US
Mailing Address - Phone:404-257-0611
Mailing Address - Fax:404-257-1289
Practice Address - Street 1:218 SANDY SPRINGS PL NE
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3812
Practice Address - Country:US
Practice Address - Phone:404-257-0611
Practice Address - Fax:404-257-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6255Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER