Organization
LIBERAL ANESTHESIA CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROMAN POHORECKI MD (OWNER)
(620) 624-1550
Entity
Organization
Contact information
Practice address
15TH AT PERSHING, LIBERAL, KS 67901-2455
(620) 624-1651
(620) 629-6655
Mailing address
PO BOX 739, LIBERAL, KS 67905-0739
(620) 624-1550
(620) 624-2545
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110697
BLUE CROSS GROUP NUMBER
KS
01
—
CJ4055
RAILROAD MEDICARE GROUP
KS
Enumeration date
06/15/2006
Last updated
08/22/2020
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