Organization
KELL ANESTHESIA BILLING COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY ALLEN ROGERS CRNA (MANAGER)
(812) 216-2954
Entity
Organization
Contact information
Practice address
4210 KELL BLVD, SUITE 200, WICHITA FALLS, TX 76309-4802
(812) 216-2954
(940) 766-3659
Mailing address
4210 KELL BLVD, SUITE 200, WICHITA FALLS, TX 76309-4802
(812) 216-2954
(940) 766-3659
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP110509
TX
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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