Basic Information
| Provider Information | |||||||||
| NPI: | 1528560646 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLUMBUS ONE ANESTHESIA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4860 | ||||||||
| Address2: | |||||||||
| City: | MURRELLS INLET | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295762698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436512624 | ||||||||
| FaxNumber: | 8434914023 | ||||||||
| Practice Location | |||||||||
| Address1: | 4600 LEAP CT STE 121 | ||||||||
| Address2: | |||||||||
| City: | HILLIARD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6146643883 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2018 | ||||||||
| LastUpdateDate: | 07/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | RAYAPUDI | ||||||||
| AuthorizedOfficialFirstName: | KRISHNA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6146643883 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207RG0100X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.