Provider Demographics
NPI:1912339110
Name:MOBILE ANESTHESIA, INC.
Entity Type:Organization
Organization Name:MOBILE ANESTHESIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-247-1294
Mailing Address - Street 1:PO BOX 25791
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-0791
Mailing Address - Country:US
Mailing Address - Phone:808-247-1294
Mailing Address - Fax:808-235-6280
Practice Address - Street 1:7192 KALANIANAOLE HWY
Practice Address - Street 2:SUITE A143A 191
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1800
Practice Address - Country:US
Practice Address - Phone:808-247-1294
Practice Address - Fax:808-235-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD14617174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty