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Organization

NMDA ANESTHESIA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD DOUBERLY CRNA (MEMBER MANAGER)
(888) 728-0882
Entity
Organization

Contact information

Practice address
577 MULBERRY ST STE 110, MACON, GA 31201-8220
(888) 728-0882
Mailing address
PO BOX 850001 DEPT 740U, ORLANDO, FL 32885-4380
(941) 360-1566

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Enumeration date
11/04/2011
Last updated
08/14/2020
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