Organization
PIEDMONT TRIAD ANESTHESIA, PA
Active
Organization
PIEDMONT TRIAD ANESTHESIA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS LUKISH III (PRACTICE ADMINISTRATOR)
(336) 768-3212
Entity
Organization
Contact information
Practice address
145 KIMEL PARK DR, SUITE 120, WINSTON-SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR, SUITE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016HA
BCBS
NC
05
—
8000325
—
NC
05
—
89016HA
—
NC
01
—
DC6484
RR MEDICARE
NC
Enumeration date
06/18/2006
Last updated
02/08/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up