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Organization
ASSOCIATED ANESTHESIOLOGISTS PA
Active
Organization
ASSOCIATED ANESTHESIOLOGISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE LYNN POPHAM (CREDENTIALING SPECIALIST)
(651) 209-8071
Entity
Organization
Contact information
Practice address
8681 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 251-8021
(651) 251-8050
Mailing address
8681 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 251-8021
(651) 251-8050
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
435
MN
367500000X
Certified Registered Nurse Anesthetist
435
MN
Other
Enumeration date
06/25/2006
Last updated
01/25/2012
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