| NPI | 1700180122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR RICHARD GRAY Chief Executive Officer 478-742-8297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 999999) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 99999) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 99999) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 99999) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: GA 99999) | |
| 367H00000X Anesthesiologist Assistant (Licence: GA 99999) | |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2011-04-29 |