Provider Demographics
NPI:1689617953
Name:ANESTHESIA SOLUTIONS OF MOBILE, INC.
Entity Type:Organization
Organization Name:ANESTHESIA SOLUTIONS OF MOBILE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHRISTIANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-633-1660
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-0610
Mailing Address - Country:US
Mailing Address - Phone:866-607-8693
Mailing Address - Fax:240-566-1680
Practice Address - Street 1:6801 AIRPORT BLVD
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3709
Practice Address - Country:US
Practice Address - Phone:251-631-3270
Practice Address - Fax:251-631-3273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529912760Medicaid
362602200OtherUS DEPARTMENT OF LABOR
MS01583765Medicaid
AL529912760Medicaid
362602200OtherUS DEPARTMENT OF LABOR