Colquitt Regional Anesthesia, LLC

NPI #1154580512 in Moultrie, Georgia

Provider Information

NPI Number: 1154580512
Entity Type: Organization
Organization Name: Colquitt Regional Anesthesia, LLC
Primary Specialty: Specialist
Enumeration Date: Jun 2, 2008
Last Updated: Jun 2, 2008

Practice Location

Address: 3131 S MAIN ST
City: Moultrie
State: Georgia
ZIP Code: 31768-6925
Phone: (229) 985-3420

Authorized Official

Name: JUDY B RICKS
Title: PROVIDER ENROLLMENT COORDINATOR
Phone: (229) 891-9131

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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