Provider Demographics
NPI:1881159085
Name:SMALL GROUP ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:SMALL GROUP ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-770-2900
Mailing Address - Street 1:7362 N 195TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8219
Mailing Address - Country:US
Mailing Address - Phone:918-704-5556
Mailing Address - Fax:866-550-2242
Practice Address - Street 1:4716 W URBANA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5997
Practice Address - Country:US
Practice Address - Phone:918-704-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREELANCE ANESTHESIA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty