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Organization

ARENA ANESTHESIA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGG ARENA MD (PRESIDENT)
(660) 826-5960
Entity
Organization

Contact information

Practice address
401 E VAUGHN AVE, RUSTON, LA 71270-5950
(660) 826-5960
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1883816
LA
01
DP2007
RR MEDICARE
LA
Enumeration date
06/09/2009
Last updated
02/20/2020
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