MEDICARE: MR. MICHAEL GEORGE THEELE CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	1059523	KY
2	367500000X	Certified Registered Nurse Anesthetist	1102A	KY
3	367500000X	Certified Registered Nurse Anesthetist	10643	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00408377	OTHER	KY	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000350186	OTHER	KY	BLUE CROSS/BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083695522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL GEORGE THEELE CRNA

Provider Business Mailing Address
First Line	:	12752 KINGSTON PIKE
Second Line	:	STE E202
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-0948
Country	:	US
Telephone Number	:	865-777-0909
Fax Number	:	865-777-0910

Provider Business Practice Location Address
First Line	:	723 BURKESVILLE HWY
Second Line	:
City	:	ALBANY
State	:	KY
Zip	:	42602-1654
Country	:	US
Telephone Number	:	865-777-0909
Fax Number	:	865-777-0910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	01/11/2011

Similar Medicare Providers

1649139643 — BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION
Practice Location Address:

723 BURKESVILLE RD
ALBANY, KY
42602-1654

Practice Phone: 606-387-6421
Practice Fax:

1366442626 — MS. JOYCE D GILL CRNA
Practice Location Address:

723 BURKESVILLE HWY
ALBANY, KY
42602-1654

Practice Phone: 606-387-6421
Practice Fax: 865-777-0910

1316939689 — CLINTON COUNTY HOSPITAL, INC.
Practice Location Address:

723 BURKESVILLE RD
ALBANY, KY
42602-1654

Practice Phone: 606-387-6421
Practice Fax: 606-387-8550

1134171630 — DR. WILLIAM ARDREY M.D.
Practice Location Address:

723 BURKESVILLE RD
ALBANY, KY
42602-1654

Practice Phone: 606-387-7090
Practice Fax:

1568568533 — ROBERT EARL HOPPES JR. MD
Practice Location Address:

723 BURKESVILLE RD
ALBANY, KY
42602-1654

Practice Phone: 606-387-6421
Practice Fax:

1184825101 — SHIRLEY K CATRON M D PSC
Practice Location Address:

701 BURKESVILLE RD
ALBANY, KY
42602-1654

Practice Phone: 606-387-0675
Practice Fax: 606-387-3149

Directions to “ MR. MICHAEL GEORGE THEELE CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.