Provider Demographics
NPI:1679876049
Name:ARRISON ANESTHESIA LLC
Entity Type:Organization
Organization Name:ARRISON ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-392-6133
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:103 CHESAPEAKE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6313
Practice Address - Country:US
Practice Address - Phone:410-392-6133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD209562Medicare PIN
MDDR3533Medicare PIN
MD209565Medicare PIN