Provider Demographics
NPI:1013958461
Name:PIASA ANESTHESIA LLC
Entity Type:Organization
Organization Name:PIASA ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRUMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-465-7177
Mailing Address - Street 1:ONE MEMORIAL DR
Mailing Address - Street 2:ANESTHESIA DEPT
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:16200
Mailing Address - Country:US
Mailing Address - Phone:618-465-7177
Mailing Address - Fax:618-465-7176
Practice Address - Street 1:ONE MEMORIAL DR
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:16200
Practice Address - Country:US
Practice Address - Phone:618-465-7177
Practice Address - Fax:618-465-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty