Organization
BOWLING GREEN ANESTHESIOLOGY ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIA DECKER (OFFICE MANAGER)
(270) 782-9994
Entity
Organization
Contact information
Practice address
1725 ASHLEY CIR, SUITE 209A, BOWLING GREEN, KY 42104-3337
(270) 782-9994
(270) 842-5048
Mailing address
PO BOX 2020, BOWLING GREEN, KY 42102-2020
(270) 782-9994
(270) 842-5048
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65908048
—
KY
Enumeration date
07/05/2006
Last updated
01/27/2010
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