Provider Demographics
NPI:1275877110
Name:DANESTHESIA INC
Entity Type:Organization
Organization Name:DANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGHART
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:501-771-4693
Mailing Address - Street 1:29111 BANDY RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9384
Mailing Address - Country:US
Mailing Address - Phone:501-771-4693
Mailing Address - Fax:
Practice Address - Street 1:29111 BANDY RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-9384
Practice Address - Country:US
Practice Address - Phone:501-771-4693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty