Provider Demographics
NPI:1669439402
Name:ANESTHESIA & PAIN CONSULTANTS, PC
Entity Type:Organization
Organization Name:ANESTHESIA & PAIN CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-424-7907
Mailing Address - Street 1:5515 UTICA RIDGE RD
Mailing Address - Street 2:STE. 600
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3928
Mailing Address - Country:US
Mailing Address - Phone:563-344-1050
Mailing Address - Fax:563-424-4579
Practice Address - Street 1:5515 UTICA RIDGE RD
Practice Address - Street 2:STE. 600
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3928
Practice Address - Country:US
Practice Address - Phone:563-344-1050
Practice Address - Fax:563-424-4579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA007248Medicaid
05359Medicare ID - Type Unspecified