Organization
PREMIER ANESTHESIA OF URBANA
Active
Organization
PREMIER ANESTHESIA OF URBANA
Active
Other names
Premier Anesthesia of Illinois
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KERRY TEEL (PRESIDENT)
(770) 643-5501
Entity
Organization
Contact information
Practice address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
(770) 643-5501
(404) 941-1304
Mailing address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
(770) 643-5501
(404) 941-1304
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
07/04/2006
Last updated
09/25/2013
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