Vidalia Anesthesia Assoc PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

VIDALIA ANESTHESIA ASSOC PC

Practice address

1703 Meadows Lane
Vidalia, GA 30474

Phone

(912) 538-5359

Fax

(912) 538-5228

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

June H Tootle

Title

Office Manager

Phone

(912) 538-5359

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1912955725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1303",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304751303",
            "telephone_number": "912-538-5359",
            "fax_number": "912-538-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MEADOWS LANE",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "30474",
            "telephone_number": "912-538-5359",
            "fax_number": "912-538-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDALIA ANESTHESIA ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "TOOTLE",
        "authorized_official_first_name": "JUNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-538-5359"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300033365A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CE7445",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twin Oaks
• Twin Oaks Living Communities
• Swayamprabha S Tyagi, MD
• Universal Community Health System LLC
• Ashley Upshaw, PHARM.D.
• Vidalia Children'S Center LLC
• Vidalia City Board of Education
• Vidalia Dental Associates,P.C.
• Vidalia ENT Associates, LLC
• Vidalia Eye Associates, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; 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.