Provider Demographics
NPI:1760063507
Name:PATIENT-CENTERED ANESTHESIA PLC
Entity Type:Organization
Organization Name:PATIENT-CENTERED ANESTHESIA PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-281-8040
Mailing Address - Street 1:303 W SPRING MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-7711
Mailing Address - Country:US
Mailing Address - Phone:517-281-8040
Mailing Address - Fax:
Practice Address - Street 1:303 W SPRING MEADOWS LN
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-7711
Practice Address - Country:US
Practice Address - Phone:517-281-8040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty