Basic Information
| Provider Information | |||||||||
| NPI: | 1609822998 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN ANESTHESIOLOGY OF TENNESSEE, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1305 WALT WHITMAN RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | MELVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117474300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162084250 | ||||||||
| FaxNumber: | 8442062955 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 20TH ST | ||||||||
| Address2: | SUITE 606 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379161809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655468040 | ||||||||
| FaxNumber: | 8655412787 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 03/03/2022 | ||||||||
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| AuthorizedOfficialLastName: | ABDOU | ||||||||
| AuthorizedOfficialFirstName: | FRANCIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8655411901 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| NPICertificationDate: | 03/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 029883100 | 01 | TN | FEDERAL BLACK LUNG | OTHER | 2006724 | 01 | TN | BLUE CROSS | OTHER | 164606500 | 01 | TN | US DEPARTMENT OF LABOR | OTHER | TN0100 | 01 | TN | JOHN DEERE TENNCARE | OTHER | 3371170 | 05 | TN | MEDICAID | CB1124 | 01 | TN | TRAVELERS MEDICARE | OTHER | TN0100 | 01 | TN | JOHN DEERE | OTHER |