Organization
IVIN ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY K NICKELL (CFO)
(706) 623-6699
Entity
Organization
Contact information
Practice address
1090 EXPERIMENT STATION RD UNIT 529, WATKINSVILLE, GA 30677-5378
(706) 623-6699
(706) 850-7733
Mailing address
1090 EXPERIMENT STATION RD UNIT 529, WATKINSVILLE, GA 30677-5378
(706) 623-6699
(706) 850-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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