Capitol Anesthesiology, PC

Organization Active NPI Anesthesiology Physician · Morrow, GA

NPI 1245287192 · NPPES record last updated Jan 10, 2013

Key facts

NPI
1245287192
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
CAPITOL ANESTHESIOLOGY, PC
Practice address
6649 Lake Dr
Morrow, GA 30260-2354
Phone
(770) 968-9978
Fax
(770) 968-9975
NPI assigned
May 27, 2006
Organization subpart
No

Authorized official

Name
Jan Kersey
Title
Administrator
Phone
(770) 968-9978

Practitioners 124

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 124

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040507000216 GA Part B Supplier - Clinic/Group Practice 5799774642 Receives reassigned benefits from 50 practitioners
Practice locations: Atlanta, GA; Fayetteville, GA; Morrow, GA; Stockbridge, GA

National Provider Directory

Locations

365 E Paces Ferry Rd NE
Atlanta, GA 30305
Phone (404) 814-0868

98 Annex
#618
Atlanta, GA 30398
Phone (770) 473-6000

1336 Highway 54 W
Bldg 400
Fayetteville, GA 30214
Phone (770) 461-1238

156 Foster Dr
Spc C
McDonough, GA 30253

6649 Lake Dr
Morrow, GA 30260

1100 Lake Hearn Dr
Ste 410
Sandy Springs, GA 30342
Phone (404) 252-9991

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207L00000X GA Yes

Addresses

Primary practice location

6649 Lake Dr
Morrow, GA 30260-2354

Mailing address

PO Box 278
Jonesboro, GA 30237-0278
Phone (770) 968-9978

Other providers in Morrow, GA

All providers in Morrow, GA · Anesthesiology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.