Provider Demographics
NPI:1770187734
Name:JACKSON ANESTHESIOLOGY GROUP, PLLC
Entity Type:Organization
Organization Name:JACKSON ANESTHESIOLOGY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:THROWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-668-1853
Mailing Address - Street 1:PO BOX 3572
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38303-3572
Mailing Address - Country:US
Mailing Address - Phone:731-668-1853
Mailing Address - Fax:
Practice Address - Street 1:131 TUCKER ST STE 2
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-4055
Practice Address - Country:US
Practice Address - Phone:731-668-1853
Practice Address - Fax:731-664-7731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty