Organization
BLUE SKY ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENT DOUGLAS SCHMIDT CRNA (OWNER/MANAGER)
(918) 916-0574
Entity
Organization
Contact information
Practice address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(660) 826-5960
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389740A
—
OK
01
—
616341700
US DEPT OF LABOR
OK
Enumeration date
08/24/2011
Last updated
02/25/2020
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