Healthcare Provider Details

I. General information

NPI: 1093449126
Provider Name (Legal Business Name): ROMAN DAVID COMER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROMAN COMER CRNA

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 PLAYERS CLUB PKWY STE 350
MEMPHIS TN
38125-8949
US

IV. Provider business mailing address

105 SMALL OAK DR
HUMBOLDT TN
38343-8646
US

V. Phone/Fax

Practice location:
  • Phone: 901-844-1590
  • Fax:
Mailing address:
  • Phone: 731-803-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7344
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024196051
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number214631
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901802
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: