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Individual

MARION WAYNE KISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
7500 STATE ROAD, ANESTHESIA INTENSIVE CARE CONSULTANTS INC, CINCINNATI, OH 45255
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DRIVE, SUITE 258 MILLENIUM ANESTHESIA LLC, EDGEWOOD, KY 41017
(859) 341-7246
(859) 341-7867

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
167349
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000277554
ANTHEM BLUE SHIELD
05
200381120
IN
05
2091196
OH
01
617582
WELLCARE
KY
01
728027
BUCKEYE
05
74005315
KY
Enumeration date
12/13/2005
Last updated
11/08/2011
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