Provider Demographics
NPI:1255718235
Name:STONESPRINGS ANESTHESIA ASSOCIATES, LTD
Entity type:Organization
Organization Name:STONESPRINGS ANESTHESIA ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-471-0919
Mailing Address - Street 1:PO BOX 2727
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20195-0727
Mailing Address - Country:US
Mailing Address - Phone:703-471-0919
Mailing Address - Fax:703-742-9081
Practice Address - Street 1:24440 STONE SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2247
Practice Address - Country:US
Practice Address - Phone:703-471-0919
Practice Address - Fax:703-742-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty