Provider Demographics
NPI:1588836597
Name:SPRINGFIELD REGIONAL ANESTHESIA, INC
Entity Type:Organization
Organization Name:SPRINGFIELD REGIONAL ANESTHESIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-298-5333
Mailing Address - Street 1:L 3159
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-1422
Mailing Address - Country:US
Mailing Address - Phone:937-298-5333
Mailing Address - Fax:
Practice Address - Street 1:1343 N FOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1422
Practice Address - Country:US
Practice Address - Phone:937-298-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty