Organization
TRIDENT ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVEN BARBER CRNA (OWNER)
(662) 231-8023
Entity
Organization
Contact information
Practice address
2773 SAINT ANDREWS DR, BELDEN, MS 38826-9412
(662) 231-8023
Mailing address
2773 SAINT ANDREWS DR, BELDEN, MS 38826-9412
(662) 231-8023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R855204
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05785021
—
MS
Enumeration date
09/20/2014
Last updated
09/20/2014
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