Provider Demographics
NPI:1497854574
Name:ANESTHESIA CONSULTANTS PC
Entity Type:Organization
Organization Name:ANESTHESIA CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-615-2200
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102-0683
Mailing Address - Country:US
Mailing Address - Phone:712-279-3500
Mailing Address - Fax:847-615-2858
Practice Address - Street 1:2720 STONE PARK BLVD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104
Practice Address - Country:US
Practice Address - Phone:712-279-3500
Practice Address - Fax:847-615-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2009-12-23
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0145581Medicaid
IA0123695Medicaid
IA26667OtherWELLMARK BCBS CRNA GROUP
IA14558OtherWELLMARK BCBS MD GROUP
IA0123695Medicaid
NE=========Medicaid
IA14558OtherWELLMARK BCBS MD GROUP
IA26667OtherWELLMARK BCBS CRNA GROUP