Provider Demographics
NPI:1477749851
Name:EAC ANESTHESIA, PC
Entity Type:Organization
Organization Name:EAC ANESTHESIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA/ OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:479-420-8552
Mailing Address - Street 1:PO BOX 5561
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72913-5561
Mailing Address - Country:US
Mailing Address - Phone:479-420-8552
Mailing Address - Fax:479-434-6003
Practice Address - Street 1:3502 S N ST
Practice Address - Street 2:APARTMENT D
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2911
Practice Address - Country:US
Practice Address - Phone:479-420-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty