Organization
MIDWEST ANESTHESIA PROVIDERS S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GORDON MD (PRESIDENT)
(865) 293-5676
Entity
Organization
Contact information
Practice address
11133 DUNN RD, SAINT LOUIS, MO 63136-6163
(865) 293-5676
Mailing address
1431 CENTERPOINT BLVD STE 100, KNOXVILLE, TN 37932-1983
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
04/18/2016
Last updated
02/18/2022
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