Basic Information
| Provider Information | |||||||||
| NPI: | 1326447236 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TC ANESTHESIA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2470 DANIELS BRIDGE RD | ||||||||
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| City: | ATHENS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 306066187 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7066236699 | ||||||||
| FaxNumber: | 7068507733 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 RICE MINE RD N | ||||||||
| Address2: | SUITE E | ||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354062300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053450010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2014 | ||||||||
| LastUpdateDate: | 12/01/2014 | ||||||||
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| AuthorizedOfficialLastName: | WEIR | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7064252239 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.