Provider Demographics
NPI:1417067885
Name:PASPOINT ANESTHESIA, PLLC
Entity Type:Organization
Organization Name:PASPOINT ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-762-9080
Mailing Address - Street 1:PO BOX 1432
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39568-1432
Mailing Address - Country:US
Mailing Address - Phone:228-762-9080
Mailing Address - Fax:228-762-0065
Practice Address - Street 1:3882 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5803
Practice Address - Country:US
Practice Address - Phone:228-872-6290
Practice Address - Fax:228-762-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS09345261QE0800X, 261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS587210340COtherBLUE CROSS BLUE SHIELD
MS9015502Medicaid
MS587210340COtherAHS STATE
MSCH7751OtherMEDICARE RAILROAD
MS9015502Medicaid
MSD73590Medicare UPIN