Provider Demographics
NPI:1184294761
Name:GSG ANESTHESIA, LLC
Entity type:Organization
Organization Name:GSG ANESTHESIA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-339-8452
Mailing Address - Street 1:721 WELLNESS WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3304
Mailing Address - Country:US
Mailing Address - Phone:770-339-8452
Mailing Address - Fax:770-277-2930
Practice Address - Street 1:721 WELLNESS WAY STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3304
Practice Address - Country:US
Practice Address - Phone:770-339-8452
Practice Address - Fax:770-277-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty