Basic Information
Provider Information
NPI: 1114421245
EntityType: 2
ReplacementNPI:  
OrganizationName: PRECISE ANESTHESIA SERVICES, PLLC
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 660257
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352660257
CountryCode: US
TelephoneNumber: 2059795882
FaxNumber: 2059791248
Practice Location
Address1: 7474 GREENWAY CENTER DR STE 1100
Address2:  
City: GREENBELT
State: MD
PostalCode: 207703500
CountryCode: US
TelephoneNumber: 3014413050
FaxNumber: 3014411148
Other Information
ProviderEnumerationDate: 03/22/2018
LastUpdateDate: 03/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HAMMOND
AuthorizedOfficialFirstName: JAMES
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 3018062428
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential: CRNA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X  Y193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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