Provider Demographics
NPI:1982765111
Name:ATTENTUS OF SCOTT COUNTY,LLC
Entity Type:Organization
Organization Name:ATTENTUS OF SCOTT COUNTY,LLC
Other - Org Name:SCOTT COUNTY HOSPITAL CRNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-569-8521
Mailing Address - Street 1:PO BOX 404803
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4803
Mailing Address - Country:US
Mailing Address - Phone:423-569-8521
Mailing Address - Fax:423-569-2897
Practice Address - Street 1:18797 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2127
Practice Address - Country:US
Practice Address - Phone:423-569-8521
Practice Address - Fax:423-569-2897
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATTENTUS OF SCOTT COUNTY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-12
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4105050OtherBCBS TN
TN3728763Medicaid
TN3728763Medicaid
TN3601205Medicare Oscar/Certification