Organization
VALLEYGATE ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA JONES (CHIEF EXECUTIVE OFFICER)
(910) 485-7070
Entity
Organization
Contact information
Practice address
2038 LITHO PLACE, FAYETTEVILLE, NC 28304
(910) 485-7070
Mailing address
2015 VALLEYGATE DR, FAYETTEVILLE, NC 28304-3757
(910) 485-7070
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
—
—
207L00000X
Anesthesiology Physician
—
—
207LP3000X
Pediatric Anesthesiology Physician
Primary
—
—
Other
Enumeration date
02/15/2018
Last updated
03/17/2018
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