Provider Demographics
NPI:1679521355
Name:ANESTHESIOLOGY MANAGEMENT INC
Entity type:Organization
Organization Name:ANESTHESIOLOGY MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-242-3003
Mailing Address - Street 1:205 W MAPLE AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-4026
Mailing Address - Country:US
Mailing Address - Phone:580-242-3003
Mailing Address - Fax:580-233-3279
Practice Address - Street 1:205 W MAPLE AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4026
Practice Address - Country:US
Practice Address - Phone:580-242-3003
Practice Address - Fax:580-233-3279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKCS1359OtherMEDICARE RR
OKCS1359OtherMEDICARE RR