OrganizationActive
Southeast Mobile Anesthesia LLC
NPI 1033433503 · Anesthesiology Physician · Hebron, KY
Provider details
- NPI number
- 1033433503
- Entity type
- Organization
- Primary specialty
- Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mark Jackson, President(859) 409-2022
- License
- 40009 (KY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1727 Coachtrail Dr
Hebron, KY 41048-8476
Phone: (859) 409-2022
Fax: (513) 332-9225
Street-level locationGet directions
Mailing address
1727 Coachtrail Dr
Hebron, KY 41048-8476
Registry dates
- Enumerated
- 2010-03-26
- Last updated
- 2010-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.