Organization
MID-SOUTH ANESTHESIA SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JUMP CRNA (SECRETARY)
(256) 566-8401
Entity
Organization
Contact information
Practice address
42024 HIGHWAY 195, HALEYVILLE, AL 35565-7054
(205) 486-5213
Mailing address
PO BOX 660257, BIRMINGHAM, AL 35266-0257
(205) 979-5882
(205) 979-1248
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135617
—
AL
Enumeration date
01/05/2007
Last updated
04/09/2012
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