Provider Demographics
NPI:1477927531
Name:BRECKSVILLE ANESTHESIA, LLC
Entity Type:Organization
Organization Name:BRECKSVILLE ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-840-2020
Mailing Address - Street 1:7001 S EDGERTON RD
Mailing Address - Street 2:STE A
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-4206
Mailing Address - Country:US
Mailing Address - Phone:440-717-0491
Mailing Address - Fax:440-717-0594
Practice Address - Street 1:7001 S EDGERTON RD
Practice Address - Street 2:STE A
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-4206
Practice Address - Country:US
Practice Address - Phone:440-717-0491
Practice Address - Fax:440-717-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty