Provider Demographics
NPI:1780908152
Name:NORTH VALLEY ANESTHESIA, LC
Entity type:Organization
Organization Name:NORTH VALLEY ANESTHESIA, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:LYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-432-2600
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84110-3810
Mailing Address - Country:US
Mailing Address - Phone:801-432-2600
Mailing Address - Fax:801-432-2668
Practice Address - Street 1:10150 CENTENNIAL PKWY
Practice Address - Street 2:SUITE 230
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4103
Practice Address - Country:US
Practice Address - Phone:801-432-2600
Practice Address - Fax:801-432-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty