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Organization
INDEPENDENT ANESTHESIOLOGISTS, PSC
Active
Organization
INDEPENDENT ANESTHESIOLOGISTS, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD PARK (PRESIDENT)
(859) 341-7246
Entity
Organization
Contact information
Practice address
580 SOUTH LOOP RD, EDGEWOOD, KY 41017
(859) 341-7246
(859) 341-7867
Mailing address
P O BX 12749, COVINGTON, KY 41012-0749
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/27/2008
Last updated
03/27/2008
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