Provider Demographics
NPI:1275823049
Name:RESOURCE ANESTHESIA
Entity Type:Organization
Organization Name:RESOURCE ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAYNIE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA, MSN, MBA
Authorized Official - Phone:865-777-0909
Mailing Address - Street 1:12752 KINGSTON PIKE STE E202
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0946
Mailing Address - Country:US
Mailing Address - Phone:865-777-0909
Mailing Address - Fax:
Practice Address - Street 1:12752 KINGSTON PIKE STE E202
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-0946
Practice Address - Country:US
Practice Address - Phone:865-777-0909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15504367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty