Provider Demographics
NPI:1750264073
Name:GEORGIA ANESTHESIA LLC
Entity type:Organization
Organization Name:GEORGIA ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANDRAC
Authorized Official - Suffix:JR
Authorized Official - Credentials:RNA
Authorized Official - Phone:770-365-7958
Mailing Address - Street 1:195 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-3309
Mailing Address - Country:US
Mailing Address - Phone:678-953-0111
Mailing Address - Fax:
Practice Address - Street 1:5909 PEACHTREE DUNWOODY RD STE 600
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-8101
Practice Address - Country:US
Practice Address - Phone:770-926-2276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty