Provider Demographics
NPI:1568713105
Name:COMMERCE ANESTHESIOLOGY LLC
Entity Type:Organization
Organization Name:COMMERCE ANESTHESIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-425-2239
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-0629
Mailing Address - Country:US
Mailing Address - Phone:866-458-0036
Mailing Address - Fax:478-929-1744
Practice Address - Street 1:807 CARROLL ST
Practice Address - Street 2:SUITE C
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-3311
Practice Address - Country:US
Practice Address - Phone:866-458-0036
Practice Address - Fax:478-929-1744
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE PLUS MEDICAL PRACTICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-22
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty