Provider Demographics
NPI:1881789477
Name:TIFFIN ANESTHESIA ASSOCIATES
Entity type:Organization
Organization Name:TIFFIN ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PRASHANT
Authorized Official - Middle Name:S
Authorized Official - Last Name:KOTHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-448-1900
Mailing Address - Street 1:485 W MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-0717
Mailing Address - Country:US
Mailing Address - Phone:419-448-1900
Mailing Address - Fax:419-448-4553
Practice Address - Street 1:485 W MARKET STREET
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-0717
Practice Address - Country:US
Practice Address - Phone:419-448-1900
Practice Address - Fax:419-448-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2071627Medicaid
OH0422680Medicaid
OH2165473Medicaid
OH0562127Medicaid
OH0422680Medicaid
OH2071627Medicaid
OH8217943Medicare PIN
OH2165473Medicaid