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Organization
PREMIER ANESTHESIA OF VIRGINIA LLC
Active
Organization
PREMIER ANESTHESIA OF VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY WALKER (VICE PRESIDENT FINANCE)
(678) 690-7812
Entity
Organization
Contact information
Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191-3311
(404) 941-1210
Mailing address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
NULL
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
08/07/2019
Last updated
02/13/2024
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