Healthcare Provider Details

I. General information

NPI: 1033265772
Provider Name (Legal Business Name): SOUTHERN TENNESSEE ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 SOUTH LOCUST AVENUE
LAWRENCEBURG TN
38464
US

IV. Provider business mailing address

PO BOX 440013
NASHVILLE TN
37244-0013
US

V. Phone/Fax

Practice location:
  • Phone: 931-762-6571
  • Fax:
Mailing address:
  • Phone: 615-620-2320
  • Fax: 615-620-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN MCLEAN
Title or Position: OWNER
Credential: M.D.
Phone: 615-620-2320