Provider Demographics
NPI:1144401753
Name:SLEEP ASSOCIATES OF EAST TENNESSEE PLLC
Entity Type:Organization
Organization Name:SLEEP ASSOCIATES OF EAST TENNESSEE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:EISENSTADT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-545-7522
Mailing Address - Street 1:DEPT 888087
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8087
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6158
Practice Address - Street 1:7540 DANNAHER WAY
Practice Address - Street 2:STE 300
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4013
Practice Address - Country:US
Practice Address - Phone:865-545-7522
Practice Address - Fax:865-545-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN31835302Medicaid
TN31835302Medicare PIN