| Byron Anderson, CRNA | |
|
5885 Bluegrass Vw, Fairburn, GA 30213-4735 | |
| (404) 748-2698 | |
| Not Available |
| Full Name | Byron Anderson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 5885 Bluegrass Vw, Fairburn, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780052704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN199166 (Georgia) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP128939 (Texas) | Secondary |
| Entity Name | Grady Memorial Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114243813 PECOS PAC ID: 7517032998 Enrollment ID: O20100723000311 |
| Entity Name | Coastal Ambulatory Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750753786 PECOS PAC ID: 1052613023 Enrollment ID: O20160107001775 |
| Entity Name | Sleep Ezzy |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154852820 PECOS PAC ID: 4486920295 Enrollment ID: O20171023003067 |
| Entity Name | Gi Anesthesia Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326569187 PECOS PAC ID: 0446516769 Enrollment ID: O20171102000283 |
| Entity Name | Jc Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821501206 PECOS PAC ID: 1456614627 Enrollment ID: O20180423000731 |
| Entity Name | Radius Anesthesia Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861996225 PECOS PAC ID: 2567897127 Enrollment ID: O20200109000552 |
| Entity Name | Anesthesia Services Of Atlanta, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124657465 PECOS PAC ID: 6406252949 Enrollment ID: O20210908001767 |
| Entity Name | Anesthesia Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588425649 PECOS PAC ID: 2062850936 Enrollment ID: O20240411000461 |
| Mailing Address | Practice Location Address |
|---|---|
| Byron Anderson, CRNA 5885 Bluegrass Vw, Fairburn, GA 30213-4735 Ph: (404) 748-2698 | Byron Anderson, CRNA 5885 Bluegrass Vw, Fairburn, GA 30213-4735 Ph: (404) 748-2698 |