Athens Anesthesia Associates, Inc.

Organization Active NPI Anesthesiology Physician · Athens, TN

NPI 1649229014 · NPPES record last updated Oct 30, 2007

Key facts

NPI
1649229014
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
ATHENS ANESTHESIA ASSOCIATES, INC.
Practice address
1114 W Madison Ave
Athens, TN 37303-4150
Phone
(423) 745-1411
NPI assigned
May 10, 2006
Organization subpart
No

Authorized official

Name
Mr. Russell E Long, CRNA
Title
President
Phone
(423) 424-3695

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060927000040 TN Part B Supplier - Clinic/Group Practice 2961407895 Receives reassigned benefits from 12 practitioners
Practice locations: Etowah, TN; Athens, TN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207L00000X Yes

Addresses

Primary practice location

1114 W Madison Ave
Athens, TN 37303-4150

Mailing address

PO Box 220
Athens, TN 37371-0220
Phone (423) 424-3695

Other identifiers

IdentifierTypeStateIssuer
3734665MedicaidTN
DF1630OtherRR MEDICARE

Other providers in Athens, TN

All providers in Athens, TN · Anesthesiology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.