Organization
INGRAM ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM SCOTT INGRAM CRNA (PRESIDENT)
(478) 231-9507
Entity
Organization
Contact information
Practice address
1750 S LUMPKIN ST, ATHENS, GA 30606-4739
(706) 353-2550
Mailing address
111 KILSPRINGS RD, ANDERSON, SC 29621-4224
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN107878
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
632655268A
—
GA
Enumeration date
11/17/2008
Last updated
09/13/2011
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