Organization
MID-MISSOURI ANESTHESIOLOGISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LIZ WILDEN (ADMINISTRATOR)
(573) 445-7300
Entity
Organization
Contact information
Practice address
ONE SOUTH KEENE STREET, THE SURGICAL CENTER AT COLUMBIA ORTHOPAEDIC GROUP, COLUMBIA, MO 65201
(573) 445-7300
(573) 445-7301
Mailing address
PO BOX 843104, KANSAS CITY, MO 64184-0001
(573) 445-7300
(573) 445-7301
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1360
BCBS RIGHT CHOICE
MO
01
—
138147
HEALTH LINK
MO
05
—
503021701
—
MO
01
—
CC7976
RAILROAD MEDICARE
MO
Enumeration date
04/06/2006
Last updated
01/26/2011
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