# SOUTH CENTRAL ANESTHESIA ASSOCIATES INC

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

## Provider details

- **NPI number:** 1194117242
- **Authorized official:** MR. JONATHAN DICKINSON (CRNA/OWNER)
- **Authorized official phone:** (270) 779-6696

## Contact information

- **Practice address:** 155 STONE TRACE DR, ALVATON, KY 42122-7809
- **Practice address phone:** (270) 779-6696
- **Practice address fax:** (615) 547-9845
- **Mailing address:** PO BOX 5000, LEBANON, TN 37088-5000
- **Mailing address phone:** (615) 444-2320
- **Mailing address fax:** (615) 547-9845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | KY | Yes |

## Other

- **Enumeration date:** 02/26/2015
- **Last updated:** 02/26/2015