Provider Demographics
NPI:1508378027
Name:ANESTHESIA ASSOCIATES OF GRAND RAPIDS, PLLC
Entity Type:Organization
Organization Name:ANESTHESIA ASSOCIATES OF GRAND RAPIDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-263-2390
Mailing Address - Street 1:2006 HOGBACK RD
Mailing Address - Street 2:STE 5A
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-263-2395
Mailing Address - Fax:734-773-3471
Practice Address - Street 1:200 JEFFERSON AVE., SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503
Practice Address - Country:US
Practice Address - Phone:616-685-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANESTHESIA ASSOCIATES OF ANN ARBOR PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty