Organization
SOUTHWEST ANESTHESIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY JULIUS CICHOCKI CRNA (OWNER/OPERATOR)
(276) 963-8504
Entity
Organization
Contact information
Practice address
2951 FRONT ST, STE 3050, RICHLANDS, VA 24641-2055
(276) 963-8504
(276) 963-6642
Mailing address
2951 FRONT ST, STE 3050, RICHLANDS, VA 24641-2055
(276) 963-8504
(276) 963-6642
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202566-000
MEDICAID WV
WV
01
—
258850
ANTHEM BCBS
VA
01
—
CH8135
RAILROAD MEDICARE
VA
Enumeration date
08/30/2006
Last updated
08/22/2020
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