Basic Information
| Provider Information | |||||||||
| NPI: | 1689816365 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRIORITY ANESTHESIA, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1003 | ||||||||
| Address2: | |||||||||
| City: | HARRIMAN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377481003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655900993 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1236 KNOXVILLE HWY | ||||||||
| Address2: | |||||||||
| City: | WARTBURG | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378874200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233466556 | ||||||||
| FaxNumber: | 4233467541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2009 | ||||||||
| LastUpdateDate: | 03/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | OCHS | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 8655900993 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | APN 10768 | TN | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | APN 10768 | 01 | TN | LICENSE | OTHER |