Organization
PARISH ANESTHESIA OF MT. SHASTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY S MARTIN (PRESIDENT/CEO)
(504) 779-5515
Entity
Organization
Contact information
Practice address
3510 N CAUSEWAY BLVD, 404, METAIRIE, LA 70002-3531
(504) 779-5515
(504) 779-5568
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
12/27/2012
Last updated
12/27/2012
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