Organization
THIRD COAST ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES J PARADISE CRNA (OWNER / PRESIDENT)
(817) 913-7459
Entity
Organization
Contact information
Practice address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 858-4000
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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