Provider Demographics
NPI:1679774343
Name:ANESTHESIA CONSULTANTS OF SAVANNAH, PC
Entity Type:Organization
Organization Name:ANESTHESIA CONSULTANTS OF SAVANNAH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:THISTLETHWAITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-354-3510
Mailing Address - Street 1:310 EISENHOWER DR
Mailing Address - Street 2:BUILDING 12, SUITE B
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-354-3510
Mailing Address - Fax:912-356-3391
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-354-3510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP8097Medicare PIN
GACG7384Medicare PIN
GACL9418Medicare PIN