Organization
OTTAWA ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON LAVERNE SAMPSON CRNA (MEMBER)
(785) 229-8200
Entity
Organization
Contact information
Practice address
1301 SOUTH MAIN, OTTAWA, KS 66067
(785) 229-8200
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111174
BCBS
KS
05
—
200331170A
—
KS
Enumeration date
02/01/2006
Last updated
08/21/2008
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