Provider Demographics
NPI:1205300696
Name:ARTISTRY ANESTHESIA ASSOCIATES LLC
Entity type:Organization
Organization Name:ARTISTRY ANESTHESIA ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRNA
Authorized Official - Phone:678-799-2396
Mailing Address - Street 1:1639 TEMPLE AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-2819
Mailing Address - Country:US
Mailing Address - Phone:678-799-2396
Mailing Address - Fax:
Practice Address - Street 1:1000 CENTRE BROOK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4573
Practice Address - Country:US
Practice Address - Phone:706-576-5939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty