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Organization
ANESTHESIOLOGY, P.A.
Active
Organization
ANESTHESIOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN Y HENDRICKS M.D. (PRESIDENT)
(763) 520-5370
Entity
Organization
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 520-5370
Mailing address
14700 28TH AVE N, SUITE 20, PLYMOUTH, MN 55447-4876
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
68
MN
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/17/2006
Last updated
02/09/2016
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