Provider Demographics
NPI:1407807142
Name:SURGICAL ANESTHESIA SERVICES, LLP
Entity Type:Organization
Organization Name:SURGICAL ANESTHESIA SERVICES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-395-1070
Mailing Address - Street 1:PO BOX 35891
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5891
Mailing Address - Country:US
Mailing Address - Phone:702-395-1070
Mailing Address - Fax:702-395-1071
Practice Address - Street 1:8440 W. LAKE MEAD BLVD.
Practice Address - Street 2:STE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7648
Practice Address - Country:US
Practice Address - Phone:702-395-1070
Practice Address - Fax:702-395-1071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVDC5882OtherRRMCR
NV100506144Medicaid
NVDC5882OtherRRMCR