Organization
MERIDIAN ANESTHESIOLOGY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON LARKIN KENNEDY (PRESIDENT)
(601) 703-9614
Entity
Organization
Contact information
Practice address
1200 16TH AVE, MERIDIAN, MS 39301-4209
(601) 485-6325
(601) 485-3061
Mailing address
1200 16TH AVE, MERIDIAN, MS 39301-4209
(601) 485-6325
(601) 485-3061
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015692
—
MS
01
—
CB3237
MEDICARE RAILROAD
GA
Enumeration date
08/13/2006
Last updated
08/31/2022
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