Provider Demographics
NPI:1922402445
Name:PERIMETER ANESTHESIA LLC
Entity Type:Organization
Organization Name:PERIMETER ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:888-408-0200
Mailing Address - Street 1:PO BOX 1186
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1003
Mailing Address - Country:US
Mailing Address - Phone:888-408-0200
Mailing Address - Fax:888-505-6721
Practice Address - Street 1:3193 HOWELL MILL RD NW STE 315
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2100
Practice Address - Country:US
Practice Address - Phone:808-408-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2021-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X
GARN146149367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty