Healthcare Provider Details
I. General information
NPI: 1235549825
Provider Name (Legal Business Name): VIGILANCE ANESTHESIA SOLUTIONS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
922 W G ST
ELIZABETHTON TN
37643-2935
US
IV. Provider business mailing address
922 W G ST
ELIZABETHTON TN
37643-2935
US
V. Phone/Fax
- Phone: 423-542-2738
- Fax:
- Phone: 423-542-2738
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
PAUL
MAY
Title or Position: DIRECTOR
Credential: M.D.
Phone: 423-542-2738