Organization
PREMIER ANESTHESIA OF VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY WALKER (VICE PRESIDENT FINANCE)
(678) 690-7812
Entity
Organization
Contact information
Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191-3311
(404) 941-1210
Mailing address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
08/07/2019
Last updated
02/13/2024
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