# SOUTH VALLEY ANESTHESIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Valley Anesthesia, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568977114
- **Authorized official:** KEVIN HENRY MD (SOLE MEMBER)
- **Authorized official phone:** (309) 868-2531

## Contact information

- **Practice address:** 36453 N GANTZEL RD STE 101, SAN TAN VALLEY, AZ 85140-7340
- **Practice address phone:** (480) 652-3338
- **Practice address fax:** (480) 652-3338
- **Mailing address:** 36453 N GANTZEL RD STE 101, SAN TAN VALLEY, AZ 85140-7340
- **Mailing address phone:** (602) 903-1527
- **Mailing address fax:** (309) 692-7226

## Taxonomy

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

## Other

- **Enumeration date:** 12/05/2017
- **Last updated:** 12/26/2019