Provider Demographics
NPI:1205135902
Name:RED RIVER ANESTHESIA OF ALEXANDRIA, LLC
Entity type:Organization
Organization Name:RED RIVER ANESTHESIA OF ALEXANDRIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:318-484-5280
Mailing Address - Street 1:PO BOX 8278
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71306-1278
Mailing Address - Country:US
Mailing Address - Phone:318-484-5280
Mailing Address - Fax:
Practice Address - Street 1:651 N BOLTON AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-7449
Practice Address - Country:US
Practice Address - Phone:318-443-3511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty