Organization
LIFEGUARD ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY GIBSON CRNA (PROVIDER)
(816) 914-2583
Entity
Organization
Contact information
Practice address
6310 E 102ND ST, TULSA, OK 74137-7061
(870) 530-4660
Mailing address
5406 E 110TH PL, TULSA, OK 74137-7253
(870) 530-4660
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
09/11/2017
Last updated
04/27/2020
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