Provider Demographics
NPI:1558456970
Name:PHYSICIAN ANESTHESIA SERVICES, LLC
Entity Type:Organization
Organization Name:PHYSICIAN ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-386-9224
Mailing Address - Street 1:351 CONSORT DR.
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011
Mailing Address - Country:US
Mailing Address - Phone:636-200-4242
Mailing Address - Fax:636-200-4243
Practice Address - Street 1:17050 BAXTER RD., SUITE #110
Practice Address - Street 2:CHESTERFIELD SURGERY CENTER
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005
Practice Address - Country:US
Practice Address - Phone:636-537-0122
Practice Address - Fax:636-537-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty