Organization
LOOKAWAY ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN SMITH MD (OWNER)
(843) 504-7194
Entity
Organization
Contact information
Practice address
101 SURGEONS DR, MYRTLE BEACH, SC 29579-5198
(843) 504-7194
Mailing address
PO BOX 681, COLUMBIA, SC 29202-0681
(803) 765-1838
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
08/10/2016
Last updated
08/29/2016
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