Organization
ELEVATED ANESTHESIA LLC
Active
Organization
ELEVATED ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA K FORDYCE (BUSINESS MANAGER)
(928) 853-4444
Entity
Organization
Contact information
Practice address
560 N SWITZER CANYON DR, FLAGSTAFF, AZ 86001-4844
(928) 774-3044
(928) 774-7107
Mailing address
560 N SWITZER CANYON DR, FLAGSTAFF, AZ 86001-4844
(928) 774-3044
(928) 774-7107
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Enumeration date
11/01/2017
Last updated
01/17/2018
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