Provider Demographics
NPI:1558763888
Name:OHIO VALLEY ANESTHETISTS LLC
Entity Type:Organization
Organization Name:OHIO VALLEY ANESTHETISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:WHITEHEAD
Authorized Official - Last Name:KEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:330-853-1490
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-5036
Mailing Address - Country:US
Mailing Address - Phone:800-240-3090
Mailing Address - Fax:304-387-5215
Practice Address - Street 1:425 W 5TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2405
Practice Address - Country:US
Practice Address - Phone:800-240-3090
Practice Address - Fax:304-387-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2323841367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty