East Tennessee Anesthesia Providers, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD0000010318 Issued in TN

Legal business name

EAST TENNESSEE ANESTHESIA PROVIDERS, PC

Practice address

10461 Wallace Alley St
Kingsport, TN 37663-3936

Phone

(423) 279-1400

NPI assigned

Aug 31, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Viktor P Sulkowski, M.D.

Title

Owner

Phone

(423) 854-0001

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319155200000",
    "number": "1669584991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BROWNS MILL RD STE 6 PMB 386",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044100",
            "telephone_number": "423-854-0001",
            "fax_number": "423-854-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-279-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE ANESTHESIA PROVIDERS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-10-21",
        "status": "A",
        "authorized_official_last_name": "SULKOWSKI",
        "authorized_official_first_name": "VIKTOR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-854-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000010318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3379190",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN PROVIDER NUMBER",
            "identifier": "4051152",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN GRP PROVIDER NUMB",
            "identifier": "4051167",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicolette Duty
• Dwight a Debow DDS PC
• Laura Dyck, MSRD
• Alison M Dyer, LPC/ MHSP
• Thomas Isaac Dykes, DPT
• East Tennessee Mind & Wellness, PLLC
• East Tennessee Podiatry Associates PLLC (Frontier Foot & Ankle Specialists)
• Wesley V Eastridge, MD
• Eric A. Echard, D.D.S
• Edward B Steffner (Atrium Medical)

• Specialist in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.