# VIGILANCE ANAESTHESIA GROUP

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

## Provider details

- **NPI number:** 1679840383
- **Authorized official:** TERRY E BUCKWALTER JR. DO (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (724) 946-8251

## Contact information

- **Practice address:** 6161 CLAIRTON RD, WEST MIFFLIN, PA 15122-2475
- **Practice address phone:** (412) 714-8346
- **Mailing address:** 255 W MICHIGAN AVE, P O BOX 1123, JACKSON, MI 49201-2218
- **Mailing address phone:** (800) 242-1131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | PA | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | PA | — |

## Other

- **Enumeration date:** 11/23/2011
- **Last updated:** 01/09/2013