# OLD DOMINION ANESTHESIA LLC

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

## Provider details

- **NPI number:** 1902248677
- **Authorized official:** ALAN OLIVER (CEO)
- **Authorized official phone:** (786) 530-3820

## Contact information

- **Practice address:** 1139 E HIGH ST STE 203, CHARLOTTESVILLE, VA 22902-4849
- **Practice address phone:** (434) 817-8484
- **Practice address fax:** (434) 817-8490
- **Mailing address:** PO BOX 71819, PHILADELPHIA, PA 19176-1819

## Taxonomy

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

## Other

- **Enumeration date:** 07/23/2013
- **Last updated:** 06/05/2026