Provider Demographics
NPI:1245303841
Name:KS ANESTHESIOLOGY LLC
Entity type:Organization
Organization Name:KS ANESTHESIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHARER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-226-4444
Mailing Address - Street 1:PO BOX 52650
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-0133
Mailing Address - Country:US
Mailing Address - Phone:888-206-5902
Mailing Address - Fax:480-466-7536
Practice Address - Street 1:350 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2602
Practice Address - Country:US
Practice Address - Phone:520-226-4444
Practice Address - Fax:520-226-8376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ112320Medicare PIN