Provider Demographics
NPI:1558364463
Name:SAVAGE, JOHN A JR (CRNA, APN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:SAVAGE
Suffix:JR
Gender:M
Credentials:CRNA, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37070-0610
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-296-9956
Practice Address - Street 1:28 WHITE BRIDGE RD STE 108
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1466
Practice Address - Country:US
Practice Address - Phone:615-352-1212
Practice Address - Fax:615-352-1215
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104541367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
3624749Medicare ID - Type Unspecified