Provider Demographics
NPI:1790839488
Name:KINGSTON ANESTHESIOLOGY PC
Entity Type:Organization
Organization Name:KINGSTON ANESTHESIOLOGY PC
Other - Org Name:SETH A KINGSTON MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL BILLER, CODER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:970-945-1443
Mailing Address - Street 1:PO BOX 2722
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2722
Mailing Address - Country:US
Mailing Address - Phone:970-945-1443
Mailing Address - Fax:970-947-9410
Practice Address - Street 1:1906 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4227
Practice Address - Country:US
Practice Address - Phone:970-945-6535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44445207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92403735Medicaid
COC807713Medicare PIN
COI56029Medicare UPIN