Organization
ANESTHESIOLOGY GROUP ASSOCIATES PC
Active
Organization
ANESTHESIOLOGY GROUP ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY L FUNKE MD (PRESIDENT)
(812) 491-1307
Entity
Organization
Contact information
Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47714-0541
(812) 491-1307
(812) 492-6307
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 491-1307
(812) 492-6307
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000055587
ANTHEM
IN
05
—
100180350
—
IN
01
—
65919813
MEDICAID
KY
01
—
C30623
RAILROAD MEDICARE
—
Enumeration date
06/20/2006
Last updated
08/31/2020
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