Provider Demographics
NPI:1649391475
Name:ANESTHESIOLOGY SERVICES NETWORK
Entity Type:Organization
Organization Name:ANESTHESIOLOGY SERVICES NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-208-4380
Mailing Address - Street 1:1 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3484 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2518
Practice Address - Country:US
Practice Address - Phone:937-208-4380
Practice Address - Fax:937-208-3843
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANESTHESIOLOGY SERVICES NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-02
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2032713Medicaid
OH2032713Medicaid