Basic Information
| Provider Information | |||||||||
| NPI: | 1679882039 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EIRING ANESTHESIA ASSOCIATES, P.C. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | EIRING ANESTHESIA ASSOCIATES,P.C. | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 PLEASANT HOME RD STE 5 | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309070518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063644171 | ||||||||
| FaxNumber: | 7063644171 | ||||||||
| Practice Location | |||||||||
| Address1: | 3658 J DEWEY GRAY CIR | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309096424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066512020 | ||||||||
| FaxNumber: | 7063644171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2010 | ||||||||
| LastUpdateDate: | 03/02/2018 | ||||||||
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| AuthorizedOfficialLastName: | DORR | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7063644171 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.