Organization
GI ANESTHESIA SERVICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LARSEN (DIRECTOR OF CREDENTIALNG)
(770) 874-5400
Entity
Organization
Contact information
Practice address
1208 HICKORY BLVD SW, LENOIR, NC 28645-6461
(828) 580-7048
Mailing address
5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA 30328-5834
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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