Provider Demographics
NPI:1639182389
Name:ANESTHESIOLOGY ASSOCIATES OF GLASGOW PSC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY ASSOCIATES OF GLASGOW PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITTA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-651-8338
Mailing Address - Street 1:206 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-1506
Mailing Address - Country:US
Mailing Address - Phone:270-651-8338
Mailing Address - Fax:270-651-3243
Practice Address - Street 1:206 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1506
Practice Address - Country:US
Practice Address - Phone:270-651-8338
Practice Address - Fax:270-651-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty