Provider Demographics
NPI:1366623837
Name:J.D. ANAESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:J.D. ANAESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DROSS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:706-533-4603
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-0567
Mailing Address - Country:US
Mailing Address - Phone:706-533-4603
Mailing Address - Fax:
Practice Address - Street 1:1433 STOVALL ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4883
Practice Address - Country:US
Practice Address - Phone:706-736-6806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID