Organization
SOUTHERN ILLINOIS ANESTHESIA LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS L GRIGGS CRNA (PRESIDENT)
(812) 473-0181
Entity
Organization
Contact information
Practice address
2030 SHERMAN DR, PRINCETON, IN 47670-1045
(812) 385-5820
(812) 385-5826
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000071585
ANTHEM
IN
05
—
200095330
—
IN
01
—
CF0120
RAILROAD MEDICARE
—
Enumeration date
06/20/2006
Last updated
02/14/2012
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