Provider Demographics
NPI:1861461360
Name:WAYNE COUNTY ANESTHESIA ASSOCIATES, PA
Entity Type:Organization
Organization Name:WAYNE COUNTY ANESTHESIA ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CECIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-736-1110
Mailing Address - Street 1:1727 W NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8114
Mailing Address - Country:US
Mailing Address - Phone:770-237-1089
Mailing Address - Fax:770-237-1124
Practice Address - Street 1:2700 WAYNE MEMORIAL DR
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9494
Practice Address - Country:US
Practice Address - Phone:919-736-1110
Practice Address - Fax:770-237-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherTAX ID NUMBER