Provider Demographics
NPI:1558479279
Name:UNIVERSITY ANESTHESIOLOGISTS, PLLC
Entity Type:Organization
Organization Name:UNIVERSITY ANESTHESIOLOGISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-305-9220
Mailing Address - Street 1:341 TRANE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6053
Mailing Address - Country:US
Mailing Address - Phone:865-588-0880
Mailing Address - Fax:865-584-3111
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:BOX U109
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3383243Medicaid
TN8532014OtherAETNA
TNCB0485OtherRAILROAD MEDICARE
TN17350OtherBLUE CROSS
KY65907859OtherKENTUCKY MEDICAID
NC7902189OtherNORTH CAROLINA MEDICAID
TN164935500OtherUS DEPT OF LABOR
TNA001-37919PZOtherCHAMPUS/TRICARE
TNA001-37919PZOtherCHAMPUS/TRICARE