Provider Demographics
NPI:1932077765
Name:PHYSICIAN ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:PHYSICIAN ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:JABREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-474-5281
Mailing Address - Street 1:180 N PARK TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7372
Mailing Address - Country:US
Mailing Address - Phone:770-474-5281
Mailing Address - Fax:770-389-8674
Practice Address - Street 1:180 N PARK TRL STE 100
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7372
Practice Address - Country:US
Practice Address - Phone:770-474-5281
Practice Address - Fax:770-389-8674
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGY OF GREATER ATLANTA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty