Organization
MERCY ANESTHESIOLOGISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THALES PAVLATOS (MANAGING DIRECTOR)
(937) 399-7164
Entity
Organization
Contact information
Practice address
100 W MAIN ST, SPRINGFIELD, OH 45502-1312
(937) 521-3900
Mailing address
2790 KILKENNY DR, SPRINGFIELD, OH 45503-1181
(937) 399-7164
(937) 717-5370
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201347
—
OH
Enumeration date
08/24/2006
Last updated
02/15/2013
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