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General NPI Number Information
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NPI Number | 1902849607
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Entity Type | Organization
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Legal Business Name | ANESTHESIA CARE OF TULLAHOMA, P.C.
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 106 W BLACKWELL ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-3556
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Country | US
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Telephone | 931-454-9810
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Fax | 931-393-1020
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Provider Business Mailing Address
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Address Line | PO BOX 415000-MSC8337
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City | NASHVILLE
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State | TN
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Zip | 37241-8337
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Country | US
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Telephone | 865-670-6199
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Fax | 865-670-6198
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN M GILES
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Credential |
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Telephone | 931-454-9810
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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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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | INDIVIDUAL PRACTIONE
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License Number State | TN
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Taxonomy #3
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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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