Organization
OLD DOMINION ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GARCIA (CEO)
(305) 468-4185
Entity
Organization
Contact information
Practice address
1139 E HIGH ST STE 203, CHARLOTTESVILLE, VA 22902-4849
(434) 817-8484
(434) 817-8490
Mailing address
PO BOX 221891, CHANTILLY, VA 20153-1891
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
07/23/2013
Last updated
06/13/2023
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