Organization
MBSC ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY K NICKELL (CFO)
(404) 334-0961
Entity
Organization
Contact information
Practice address
827 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 286-2020
(843) 286-2030
Mailing address
PO BOX 529, WATKINSVILLE, GA 30677-0013
(800) 208-6014
(706) 850-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
05/25/2023
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