Provider Demographics
NPI:1467296871
Name:WEST PACES ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:WEST PACES ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:REBEKAH
Authorized Official - Last Name:VAIL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-390-3294
Mailing Address - Street 1:3200 DOWNWOOD CIR NW STE 400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1624
Mailing Address - Country:US
Mailing Address - Phone:404-390-3294
Mailing Address - Fax:404-390-3212
Practice Address - Street 1:3200 DOWNWOOD CIR NW STE 400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1624
Practice Address - Country:US
Practice Address - Phone:404-390-3294
Practice Address - Fax:404-390-3212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST PACES SURGERY CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty