Provider Demographics
NPI:1134509680
Name:GENERAL ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:GENERAL ANESTHESIA SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLEY
Authorized Official - Suffix:II
Authorized Official - Credentials:CRNA
Authorized Official - Phone:850-251-2511
Mailing Address - Street 1:PO BOX 243
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31539-0243
Mailing Address - Country:US
Mailing Address - Phone:912-253-8480
Mailing Address - Fax:
Practice Address - Street 1:163 S TALLAHASSEE ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6465
Practice Address - Country:US
Practice Address - Phone:912-253-8480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-30
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty