| Phoenix Anesthesia Specialists, Llc | |
|
1615 Petroglyph Point Dr Prescott AZ 86301-6539 | |
| (325) 660-5535 | |
| Not Available |
| Full Name | Phoenix Anesthesia Specialists, Llc |
|---|---|
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1615 Petroglyph Point Dr, Prescott, Arizona |
| Authorized Official Name and Position | Poppy Walker (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 3256605535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Anesthesia Specialists, Llc 5242 W Whispering Wind Dr Glendale AZ 85310-2908 Ph: (325) 660-5535 | Phoenix Anesthesia Specialists, Llc 1615 Petroglyph Point Dr Prescott AZ 86301-6539 Ph: (325) 660-5535 |
| NPI Number | 1932733565 |
|---|---|
| Provider Enumeration Date | 02/21/2020 |
| Last Update Date | 12/09/2020 |
| Certification Date | 12/09/2020 |
| Medicare PECOS PAC ID | 7618305913 |
|---|---|
| Medicare Enrollment ID | O20200320000633 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932733565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | (* (Not Available)) | Primary |
| Provider Name | Matthew Sauget |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740415157 PECOS PAC ID: 0446398788 Enrollment ID: I20150923003061 |
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