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Organization

INDEPENDANT ANESTHESIOLOGISTS PSC

Active
Parent organization
INDEPENDANT ANESTHESIOLOGISTS PSC
Other names
CRNA Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
INDEPENDANT ANESTHESIOLOGISTS PSC
Authorized official
RICHARD ELDON PARK MD (PRESIDENT)
(859) 341-7246
Entity
Organization

Contact information

Practice address
ONE MEDICAL VILLAGE DRIVE, EDGEWOOD, KY 41017
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DRIVE, 258, EDGEWOOD, KY 41017
(859) 341-7246
(859) 341-7867

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74905910
KY
Enumeration date
02/12/2008
Last updated
05/01/2008
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