Provider Demographics
NPI:1275650335
Name:DANESTHESIA CRNA SERVICES, LLC
Entity Type:Organization
Organization Name:DANESTHESIA CRNA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:706-836-2397
Mailing Address - Street 1:1362 WATERSTON DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5037
Mailing Address - Country:US
Mailing Address - Phone:706-836-2397
Mailing Address - Fax:706-364-6593
Practice Address - Street 1:1362 WATERSTON DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-5037
Practice Address - Country:US
Practice Address - Phone:706-836-2397
Practice Address - Fax:706-364-6593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7491Medicare ID - Type UnspecifiedMEDICARE GROUP#