Provider Demographics
NPI:1174950984
Name:PRECISION ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:PRECISION ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:E
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:740-310-6743
Mailing Address - Street 1:66325 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43718-9775
Mailing Address - Country:US
Mailing Address - Phone:740-310-6743
Mailing Address - Fax:
Practice Address - Street 1:68 STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:OH
Practice Address - Zip Code:43912-1642
Practice Address - Country:US
Practice Address - Phone:740-994-0900
Practice Address - Fax:740-609-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty