Provider Demographics
NPI:1417384488
Name:NORTH MACON ANESTHESIA LLC
Entity Type:Organization
Organization Name:NORTH MACON ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-745-6576
Mailing Address - Street 1:PO BOX 936156
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6156
Mailing Address - Country:US
Mailing Address - Phone:877-244-9741
Mailing Address - Fax:877-244-9741
Practice Address - Street 1:5400 BOWMAN RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-8879
Practice Address - Country:US
Practice Address - Phone:478-745-6576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGY SPECIALISTS SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty