Healthcare Provider Details

I. General information

NPI: 1750399127
Provider Name (Legal Business Name): ANESTHESIA AND PAIN CONSULTANTS,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 LARK ST STE 2
JOHNSON CITY TN
37604-8218
US

IV. Provider business mailing address

1009 NOVUS DR STE 2
JOHNSON CITY TN
37604-8237
US

V. Phone/Fax

Practice location:
  • Phone: 423-283-0776
  • Fax: 423-283-0549
Mailing address:
  • Phone: 423-283-0776
  • Fax: 423-283-0549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PARRY QUALLS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 423-283-0776