Provider Demographics
NPI:1689317208
Name:EXCELLE ANESTHESIA SERVICES, INC.
Entity Type:Organization
Organization Name:EXCELLE ANESTHESIA SERVICES, INC.
Other - Org Name:JACQUELINE POWELL MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-619-2464
Mailing Address - Street 1:11906 BEDFORDSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8516
Mailing Address - Country:US
Mailing Address - Phone:502-619-2464
Mailing Address - Fax:
Practice Address - Street 1:2215 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3602
Practice Address - Country:US
Practice Address - Phone:502-619-2464
Practice Address - Fax:279-444-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty