Provider Demographics
NPI:1033466354
Name:RESOURCE ANESTHESIA EAST TENNESSEE INC
Entity Type:Organization
Organization Name:RESOURCE ANESTHESIA EAST TENNESSEE INC
Other - Org Name:RESOURCE ANESTHESIA PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:HAYNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-777-0909
Mailing Address - Street 1:12752 KINGSTON PIKE
Mailing Address - Street 2:SUITE E202
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0948
Mailing Address - Country:US
Mailing Address - Phone:865-777-0909
Mailing Address - Fax:865-777-0910
Practice Address - Street 1:435 2ND ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3703
Practice Address - Country:US
Practice Address - Phone:423-625-2200
Practice Address - Fax:865-777-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty