Provider Demographics
NPI:1821042342
Name:FALLS ANESTHESIA GROUP INC
Entity type:Organization
Organization Name:FALLS ANESTHESIA GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMILEK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-971-0401
Mailing Address - Street 1:2106 ALBERTSON PKWY
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2502
Mailing Address - Country:US
Mailing Address - Phone:330-971-7000
Mailing Address - Fax:330-296-6535
Practice Address - Street 1:1900 23RD ST
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1404
Practice Address - Country:US
Practice Address - Phone:330-971-7000
Practice Address - Fax:330-296-6535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2641136Medicaid
OH2641136Medicaid