Organization
WYPA ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY K NICKELL (CFO)
(404) 334-0961
Entity
Organization
Contact information
Practice address
1 GRANITE POINT DR STE 200, WYOMISSING, PA 19610-1992
(800) 208-6014
(706) 850-7733
Mailing address
1090 EXPERIMENT STATION RD UNIT 529, WATKINSVILLE, GA 30677-5378
(706) 623-6699
(706) 850-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
06/23/2022
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