Excalibur Anesthesia Associates Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

EXCALIBUR ANESTHESIA ASSOCIATES INC

Practice address

1301 Sigman Rd NE
Suite 120
Conyers, GA 30012-3812

Phone

(770) 760-9360

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Roy L Talley Jr., MD

Title

Owner

Phone

(770) 760-9360

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1679933774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300120776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE",
            "address_2": "SUITE 120",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123812",
            "telephone_number": "770-760-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCALIBUR ANESTHESIA ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "TALLEY",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-760-9360",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kymbyatta G Evans, RN, BSN
• Melanie Evans
• Orlando Evans
• Vannessa Evans, MD
• Zina L. Evans, LCSW
• Extraordinary Hand Over Hands Associates (Ehoha) LLC
• Melissa Fagan
• Jennifer W Fagbemi, EDS
• Latresia Fair, RN
• Jamie H Fairchild

• Anesthesiology Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.