Organization
ANESTHESIA SERVICES OF ALBEMARLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT KOPP MD (MANAGING PARTNER)
(252) 335-0531
Entity
Organization
Contact information
Practice address
1144 N ROAD ST, ELIZABETH CITY, NC 27909-3353
(252) 335-0531
Mailing address
PO BOX 5368, HIGH POINT, NC 27262-5368
(800) 800-1617
(717) 653-6978
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014CO
BLUE SHIELD
NC
05
—
89014CP
—
NC
01
—
CK5462
RR MEDICARE
NC
Enumeration date
10/03/2006
Last updated
10/04/2007
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