Provider Demographics
NPI:1316552433
Name:WEST PARK ANESTHESIA, LLC
Entity Type:Organization
Organization Name:WEST PARK ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TASSET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-387-0510
Mailing Address - Street 1:11221 ROE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1941
Mailing Address - Country:US
Mailing Address - Phone:913-387-0510
Mailing Address - Fax:
Practice Address - Street 1:300 S MOUNT AUBURN RD STE 200B
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4902
Practice Address - Country:US
Practice Address - Phone:573-225-5869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty