Organization
ELITE ANESTHESIA PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L MARCANTEL CRNA (PRESIDENT)
(318) 419-0756
Entity
Organization
Contact information
Practice address
815 S 10TH ST, DOCTORS HOSPITAL @ DEER CREEK ANESTHESIOLOGY DEPT, LEESVILLE, LA 71446-4611
(337) 392-5088
Mailing address
6000 BOCAGE DR, ALEXANDRIA, LA 71303-2191
(318) 419-0756
(337) 392-4982
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2116908
—
LA
Enumeration date
05/11/2010
Last updated
02/15/2011
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