Healthcare Provider Details

I. General information

NPI: 1649773292
Provider Name (Legal Business Name): ELITE ANESTHESIA PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2018
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 N LYERLY ST STE 200
CHATTANOOGA TN
37404-2728
US

IV. Provider business mailing address

111 CONTINENTAL DR STE 412
NEWARK DE
19713-4332
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-0850
  • Fax:
Mailing address:
  • Phone: 888-709-3118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateTN

VIII. Authorized Official

Name: JAMES SCOTT NATION
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 423-653-6620