Provider Demographics
NPI:1144863549
Name:AS NEEDED ANESTHESIA
Entity type:Organization
Organization Name:AS NEEDED ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:HYRUM
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:480-266-8916
Mailing Address - Street 1:2747 E LEHI RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-9731
Mailing Address - Country:US
Mailing Address - Phone:480-266-8916
Mailing Address - Fax:
Practice Address - Street 1:4045 E BELL RD STE 127
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2234
Practice Address - Country:US
Practice Address - Phone:602-567-5944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty