Provider Demographics
NPI:1528070562
Name:TUCKER ANESTHESIA SERVICES, LLC
Entity type:Organization
Organization Name:TUCKER ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:615-620-2320
Mailing Address - Street 1:PO BOX 291264
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1264
Mailing Address - Country:US
Mailing Address - Phone:615-620-2321
Mailing Address - Fax:615-620-2323
Practice Address - Street 1:105 REDBUD DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-1673
Practice Address - Country:US
Practice Address - Phone:615-620-2321
Practice Address - Fax:615-620-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty