Provider Demographics
NPI:1912999343
Name:SOUTHERN ARIZONA ANESTHESIA SERVICES, PC
Entity Type:Organization
Organization Name:SOUTHERN ARIZONA ANESTHESIA SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-784-2244
Mailing Address - Street 1:3390 N CAMPBELL AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-2380
Mailing Address - Country:US
Mailing Address - Phone:520-795-7650
Mailing Address - Fax:520-325-1622
Practice Address - Street 1:3390 N CAMPBELL AVE
Practice Address - Street 2:STE 110
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2380
Practice Address - Country:US
Practice Address - Phone:520-795-7650
Practice Address - Fax:520-325-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ=========OtherTAX ID NUMBER
AZZWCHGGMedicare PIN