Basic Information
Provider Information
NPI: 1417303116
EntityType: 2
ReplacementNPI:  
OrganizationName: ANESTHESIA SERVICES ASSOCIATES PLLC
LastName:  
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OtherOrganizationName: COMPREHENSIVE PAIN SPECIALISTS
OtherOrganizationType: 3
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Mailing Information
Address1: 131 SAUNDERSVILLE RD
Address2: SUITE 160
City: HENDERSONVILLE
State: TN
PostalCode: 370758903
CountryCode: US
TelephoneNumber: 6158243737
FaxNumber:  
Practice Location
Address1: 120 STONE CREEK BLVD
Address2: SUITE 500
City: FLOWOOD
State: MS
PostalCode: 392328205
CountryCode: US
TelephoneNumber: 6014202040
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/11/2016
LastUpdateDate: 05/11/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: KROLL
AuthorizedOfficialFirstName: PETER
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 6158243737
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 
363A00000X  N193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363L00000X  N193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
207LP2900X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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