Provider Demographics
NPI:1487677845
Name:PORTSMOUTH ANESTHESIA ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PORTSMOUTH ANESTHESIA ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUSEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-399-7456
Mailing Address - Street 1:355 CRAWFORD ST
Mailing Address - Street 2:SUITE 808
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-2816
Mailing Address - Country:US
Mailing Address - Phone:757-399-7451
Mailing Address - Fax:757-399-1158
Practice Address - Street 1:3200 TYRE NECK RD STE 101
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703
Practice Address - Country:US
Practice Address - Phone:757-399-7451
Practice Address - Fax:757-399-1158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03279Medicare ID - Type Unspecified