Olde Town Anesthesia Associates, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101035966 Issued in VA

Legal business name

OLDE TOWN ANESTHESIA ASSOCIATES, PC

Practice address

4000 Mitchellville Rd
Suite B322
Bowie, MD 20716-3104

Phone

(703) 820-6418

NPI assigned

Mar 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Lee Lyles Jr., MD, PHD

Title

President

Phone

(703) 820-6418

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073647178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021347",
            "telephone_number": "703-820-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE B322",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "703-820-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDE TOWN ANESTHESIA ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-820-6418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101035966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bukola Olaoye
• Toyin Olasehinde
• Oyinlola A Olasewere, P.A.
• Adefemi Olatunde
• Josephine Olayinka
• Abayomi Olumide Olorunfemi
• Olajesu Olorunfemi
• Azeezat Olorunoje
• Olubunmi Olugemo, PMHNP
• Nnena Eke Olugu

• Specialist in Bowie, MD
• Providers in Bowie, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.