Provider Demographics
NPI:1134274392
Name:CARROLL COUNTY ANESTHESIA, P.C.
Entity type:Organization
Organization Name:CARROLL COUNTY ANESTHESIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CRAN-CARTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-642-8883
Mailing Address - Street 1:1188 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-3206
Mailing Address - Country:US
Mailing Address - Phone:731-642-8883
Mailing Address - Fax:731-642-8997
Practice Address - Street 1:1188 N MARKET ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-3206
Practice Address - Country:US
Practice Address - Phone:731-642-8883
Practice Address - Fax:731-642-8997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38803174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3726534Medicaid
TN1861494676OtherNPI FOR DR. CRAN-CARTY,
TN3726534Medicaid
TN3726534Medicare ID - Type UnspecifiedGROUP NUMBER
TNI16978Medicare UPIN