Organization
MURRAY ANESTHESIA GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L YATES MD (AUTHORIZED REPRESENTATIVE)
(270) 762-1100
Entity
Organization
Contact information
Practice address
803 POPLAR ST, MURRAY, KY 42071-2432
(270) 762-1100
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65945917
—
KY
05
—
74901059
—
KY
Enumeration date
06/07/2006
Last updated
09/20/2007
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