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East Tennessee Anesthesia Providers, Pc
Specialist in Kingsport, Tennessee
NPI 1669584991

East Tennessee Anesthesia Providers, Pc is a Specialist based in Johnson City, TN. East Tennessee Anesthesia Providers, Pc practices in Kingsport, TN. The NPI Number for East Tennessee Anesthesia Providers, Pc is 1669584991 and holds a License No. MD0000010318 (Tennessee).

The current practice location address for East Tennessee Anesthesia Providers, Pc is 10461 Wallace Alley St, Kingsport, TN and can be reached out via phone at 423-279-1400.

Location: 10461 Wallace Alley St, Kingsport, TN, 37604-4100
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1669584991
Provider Name
East Tennessee Anesthesia Providers, Pc
Credential
Provider Entity Type
Organization
Address
10461 Wallace Alley St, Kingsport, TN, 37604-4100
Phone Number
423-279-1400
Fax Number
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3379190 05 TN
4051152 01 TN BCBS TN PROVIDER NUMBER
4051167 01 TN BCBS TN GRP PROVIDER NUMB
institution
Provider Business Practice Location Address Details
Address
10461 Wallace Alley St
City
Kingsport
State
Tennessee
Zip
37663-3936
Phone Number
423-279-1400
Fax Number
person
Provider Business Mailing Address Details
Address
10461 Wallace Alley St
City
Kingsport
State
Tennessee
Zip
37663-3936
Phone Number
423-279-1400
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MD0000010318 (Tennessee)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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