Provider Demographics
NPI:1023412996
Name:ANESTHESIA SERVICES ASSOCIATES, PLLC
Entity type:Organization
Organization Name:ANESTHESIA SERVICES ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:WIDDIFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-472-1140
Mailing Address - Street 1:1726 GUNBARREL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3127
Mailing Address - Country:US
Mailing Address - Phone:423-425-9694
Mailing Address - Fax:
Practice Address - Street 1:1726 GUNBARREL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3127
Practice Address - Country:US
Practice Address - Phone:423-425-9694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty