Organization
BLACK MOUNTAIN ANESTHESIA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN KEITH PRESCOTT MSNA (CRNA)
(918) 850-5607
Entity
Organization
Contact information
Practice address
750 HOSPITAL LOOP, CRAIG, CO 81625-8750
(970) 824-3000
Mailing address
1255 LECUYER DR, CRAIG, CO 81625-1438
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0205032
CO
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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