Provider Demographics
NPI:1073554960
Name:HIGHLAND RIM ANESTHESIA, P.C.
Entity Type:Organization
Organization Name:HIGHLAND RIM ANESTHESIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:DESUNDRE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:931-455-3649
Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-0402
Mailing Address - Country:US
Mailing Address - Phone:877-732-3978
Mailing Address - Fax:770-238-3883
Practice Address - Street 1:1801 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-8259
Practice Address - Country:US
Practice Address - Phone:931-455-3649
Practice Address - Fax:770-238-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3381702Medicare PIN
TN3606212Medicare PIN
TNC13865Medicare PIN