Provider Demographics
NPI:1346911542
Name:MRC ANESTHESIA LLC
Entity Type:Organization
Organization Name:MRC ANESTHESIA LLC
Other - Org Name:MRC ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-746-6380
Mailing Address - Street 1:105 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2381
Mailing Address - Country:US
Mailing Address - Phone:770-800-3455
Mailing Address - Fax:770-284-8380
Practice Address - Street 1:105 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2381
Practice Address - Country:US
Practice Address - Phone:770-800-3455
Practice Address - Fax:770-284-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty