Provider Demographics
NPI: | 1861766271 |
---|---|
Name: | AMSURG DURHAM ANESTHESIA LLC |
Entity type: | Organization |
Organization Name: | AMSURG DURHAM ANESTHESIA LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | BILLIE |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | PAYNE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 615-665-1283 |
Mailing Address - Street 1: | 20 BURTON HILLS BLVD |
Mailing Address - Street 2: | FLOOR 5 |
Mailing Address - City: | NASHVILLE |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 37215-6197 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 615-665-1283 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 249 E NC HIGHWAY 54 |
Practice Address - Street 2: | SUITE 210 |
Practice Address - City: | DURHAM |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27713-7512 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-544-4887 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-03-02 |
Last Update Date: | 2023-09-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Single Specialty |