Organization
ANESTHESIA CARE OF BLOOMINGTON PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN D HILLARD (CFO)
(336) 899-1412
Entity
Organization
Contact information
Practice address
4011 S MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-8000
(812) 825-1111
Mailing address
PO BOX 10483, BIRMINGHAM, AL 35202-0483
(205) 322-1808
(205) 322-1851
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200889750A
—
IN
Enumeration date
01/03/2008
Last updated
05/12/2008
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