Provider Demographics
NPI:1023252087
Name:NORTHERN LIGHTS ANESTHESIA LLC
Entity type:Organization
Organization Name:NORTHERN LIGHTS ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:307-760-9532
Mailing Address - Street 1:1150 S COLONY WAY STE 3
Mailing Address - Street 2:PMB 111
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6972
Mailing Address - Country:US
Mailing Address - Phone:307-760-9532
Mailing Address - Fax:
Practice Address - Street 1:1901 N HEMMER RD STE 111
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9690
Practice Address - Country:US
Practice Address - Phone:907-745-8000
Practice Address - Fax:907-745-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty