Provider Demographics
NPI:1801128202
Name:SOUTHWEST ALABAMA ANESTHESIA GROUP, LLC.
Entity type:Organization
Organization Name:SOUTHWEST ALABAMA ANESTHESIA GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCPHAUL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:251-362-7549
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:EXCEL
Mailing Address - State:AL
Mailing Address - Zip Code:36439-0124
Mailing Address - Country:US
Mailing Address - Phone:800-204-0099
Mailing Address - Fax:336-882-2216
Practice Address - Street 1:2016 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-3044
Practice Address - Country:US
Practice Address - Phone:251-575-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty