Healthcare Provider Details

I. General information

NPI: 1689982431
Provider Name (Legal Business Name): TENNESSEE ANESTHESIA NETWORK SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PHYSICIANS DR
JACKSON TN
38305-2071
US

IV. Provider business mailing address

PO BOX 890684
CHARLOTTE NC
28289-0684
US

V. Phone/Fax

Practice location:
  • Phone: 731-661-0086
  • Fax:
Mailing address:
  • Phone: 866-877-2762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: GERALD HAMRICK
Title or Position: OWNER
Credential: MD
Phone: 866-877-2762