Provider Demographics
NPI:1295162816
Name:ANESTHESIA SERVICES ASSOCIATES, PLLC
Entity type:Organization
Organization Name:ANESTHESIA SERVICES ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:615-476-1728
Mailing Address - Street 1:495 DUNLOP LN STE 106
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5296
Mailing Address - Country:US
Mailing Address - Phone:855-806-6042
Mailing Address - Fax:855-604-8105
Practice Address - Street 1:495 DUNLOP LN STE 106
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5296
Practice Address - Country:US
Practice Address - Phone:855-806-6042
Practice Address - Fax:855-604-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336M0002X
TN52673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142845OtherPK
TNQ032572Medicaid