Organization
ARIAH ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN PATRICK REGAN CRNA (SOLE MEMBER)
(605) 209-3272
Entity
Organization
Contact information
Practice address
4417 W GORE BLVD STE 3, LAWTON, OK 73505-5978
(580) 357-1002
Mailing address
PO BOX 232, MEDICINE PARK, OK 73557-0232
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R97399
OK
Other
Enumeration date
04/11/2012
Last updated
09/24/2012
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