# LOOKAWAY ANESTHESIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043764814
- **Authorized official:** RYAN SMITH MD (OWNER)
- **Authorized official phone:** (843) 504-7194

## Contact information

- **Practice address:** 101 SURGEONS DR, MYRTLE BEACH, SC 29579-5198
- **Practice address phone:** (843) 504-7194
- **Mailing address:** PO BOX 681, COLUMBIA, SC 29202-0681
- **Mailing address phone:** (803) 765-1838

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |
| 367H00000X | Anesthesiologist Assistant | — | NULL | — |
| 367H00000X | Anesthesiologist Assistant | — | — | — |

## Other

- **Enumeration date:** 08/10/2016
- **Last updated:** 08/29/2016