Provider Demographics
NPI:1609120070
Name:ECGJ ANESTHESIA LLC
Entity Type:Organization
Organization Name:ECGJ ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT BOARD OF MANAGERS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-345-6868
Mailing Address - Street 1:401 COMMERCE ST
Mailing Address - Street 2:STE 600
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2446
Mailing Address - Country:US
Mailing Address - Phone:615-843-4102
Mailing Address - Fax:615-691-7214
Practice Address - Street 1:1035 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8122
Practice Address - Country:US
Practice Address - Phone:615-346-5879
Practice Address - Fax:615-346-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty