Organization
ARENA ANESTHESIA LLC
Active
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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