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General NPI Number Information
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NPI Number | 1215932413
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Entity Type | Organization
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Legal Business Name | ANESTHESIA MEDICAL GROUP, PC
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 110 29TH AVE N STE 301
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City | NASHVILLE
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State | TN
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Zip | 37203
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Country | US
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Telephone | 615-327-4304
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Fax | 615-327-5435
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Provider Business Mailing Address
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Address Line | 110 29TH AVE N STE 301
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City | NASHVILLE
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State | TN
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Zip | 37203-1448
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Country | US
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Telephone | 615-327-4304
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Fax | 615-327-5435
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Authorized Official
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Title or Position | MD
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Name | MR. PATRICK FORREST
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Credential |
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Telephone | 615-327-4304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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