Provider Demographics
NPI:1205318029
Name:AT YOUR SERVICE ANESTHESIA, LLC
Entity type:Organization
Organization Name:AT YOUR SERVICE ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SELWYNN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-395-6076
Mailing Address - Street 1:PO BOX 870822
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-0021
Mailing Address - Country:US
Mailing Address - Phone:470-395-6076
Mailing Address - Fax:470-745-0716
Practice Address - Street 1:2056 W PARK PLACE BLVD STE F
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3537
Practice Address - Country:US
Practice Address - Phone:470-395-6076
Practice Address - Fax:470-745-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty