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General NPI Number Information
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NPI Number | 1619265550
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Entity Type | Organization
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Legal Business Name | TENNESSEE ANESTHESIOLOGY LLC
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 2204 PAVILION DR SUITE 105
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City | KINGSPORT
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State | TN
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Zip | 37660-4657
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Country | US
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Telephone | 423-392-0344
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Fax | 423-392-6159
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Provider Business Mailing Address
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Address Line | 2204 PAVILION DR SUITE 105
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City | KINGSPORT
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State | TN
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Zip | 37660-4657
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Country | US
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Telephone | 423-392-6100
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Fax | 423-392-6159
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | PENNY LEIGH LLOYD
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Credential |
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Telephone | 423-392-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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