# CAROLINA ANESTHESIA INC

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

## Provider details

- **NPI number:** 1558333773
- **Authorized official:** TIMOTHY WILSON MD (ANESTHESIOLOGIST)
- **Authorized official phone:** (803) 765-1838

## Contact information

- **Practice address:** 129 NORTH WASHINGTON ST, SUMTER, SC 29150
- **Practice address phone:** (803) 436-5582
- **Practice address fax:** (803) 436-0085
- **Mailing address:** PO BOX 3380, SUMTER, SC 29151
- **Mailing address phone:** (803) 765-1838
- **Mailing address fax:** (803) 765-1732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |

## Other

- **Enumeration date:** 02/02/2006
- **Last updated:** 05/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP0979 | — | SC |