Provider Demographics
NPI:1871647602
Name:ASSOCIATES IN EAR, NOSE, THROAT/HEAD AND NECK
Entity Type:Organization
Organization Name:ASSOCIATES IN EAR, NOSE, THROAT/HEAD AND NECK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIENING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-267-6738
Mailing Address - Street 1:P.O. BOX 669
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4905
Mailing Address - Country:US
Mailing Address - Phone:423-267-6738
Mailing Address - Fax:423-209-9106
Practice Address - Street 1:1724 HAMIL ROAD
Practice Address - Street 2:STE 102 OASIS PARK BUILDING I
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4905
Practice Address - Country:US
Practice Address - Phone:423-267-6738
Practice Address - Fax:423-209-9106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174400000X
207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3705735Medicare UPIN