Provider Demographics
NPI:1730332610
Name:GI ANESTHESIA, LLC
Entity type:Organization
Organization Name:GI ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJKAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-396-2602
Mailing Address - Street 1:1530 NEEDMORE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3969
Mailing Address - Country:US
Mailing Address - Phone:937-534-7330
Mailing Address - Fax:937-395-3682
Practice Address - Street 1:1530 NEEDMORE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3969
Practice Address - Country:US
Practice Address - Phone:937-534-7330
Practice Address - Fax:937-395-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2917115Medicaid
OH9379681Medicare UPIN