Provider Demographics
NPI:1801966965
Name:PANHANDLE ANESTHESIA ASSOCIATES PC
Entity type:Organization
Organization Name:PANHANDLE ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-635-7362
Mailing Address - Street 1:TWO WEST 42ND STREET
Mailing Address - Street 2:STE 1500
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361
Mailing Address - Country:US
Mailing Address - Phone:308-635-7362
Mailing Address - Fax:308-635-0426
Practice Address - Street 1:TWO WEST 42ND STREET
Practice Address - Street 2:STE 1500
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361
Practice Address - Country:US
Practice Address - Phone:308-635-7362
Practice Address - Fax:308-635-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C04211OtherRR MED
07762OtherBCBS
07762OtherBCBS
NE=========15Medicaid
095652Medicare ID - Type Unspecified