Organization
MAXIMUS ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ALEXANDER LEATHERWOOD CRNA (PRESIDENT)
(478) 986-8027
Entity
Organization
Contact information
Practice address
4030 RIVERSIDE PARK BLVD, MACON, GA 31210-1365
(478) 474-2200
(478) 314-0740
Mailing address
6094 14TH ST W # 119, BRADENTON, FL 34207-4104
(941) 360-1566
(941) 358-9818
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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