Organization
SC ANESTHESIA LLC
Active
Organization
SC ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD JOSEPH CRNA (OWNER)
(405) 514-4786
Entity
Organization
Contact information
Practice address
2001 CRADDUCK RD, ADA, OK 74820-9400
(405) 514-4786
(405) 758-5582
Mailing address
480 HICKORY HILL DR, CHOCTAW, OK 73020-7476
(405) 514-4786
(405) 758-5354
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201150800A
—
OK
Enumeration date
03/30/2023
Last updated
08/27/2026
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