Organization
CRESCENT ANESTHESIA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS ELLINGTON (PRESIDENT)
(864) 591-1540
Entity
Organization
Contact information
Practice address
1700 SKYLYN DR, SPARTANBURG, SC 29307-1041
(864) 573-3000
Mailing address
158 W MAIN ST, SPARTANBURG, SC 29306-2333
(864) 591-1540
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4124
—
SC
Enumeration date
08/03/2006
Last updated
11/06/2007
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