Provider Demographics
NPI:1598025504
Name:WEST PLAINS ANESTHESIA, LLC
Entity Type:Organization
Organization Name:WEST PLAINS ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-256-1400
Mailing Address - Street 1:1401 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-4754
Mailing Address - Country:US
Mailing Address - Phone:417-256-1400
Mailing Address - Fax:417-256-2885
Practice Address - Street 1:1401 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-4754
Practice Address - Country:US
Practice Address - Phone:417-256-1400
Practice Address - Fax:417-256-2885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST PLAINS AMBULATORY SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical