Organization
FAIRLAWN SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN EVANS MD (PRESIDENT)
(412) 418-6077
Entity
Organization
Contact information
Practice address
2030 STEPHENSON AVE SW, ROANOKE, VA 24014-1664
(540) 904-6170
Mailing address
2030 STEPHENSON AVE SW, ROANOKE, VA 24014-1664
(540) 904-6170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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