Organization
SOUTHERN TENNESSEE ANESTHESIA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MCLEAN M.D. (OWNER)
(615) 620-2320
Entity
Organization
Contact information
Practice address
1607 SOUTH LOCUST AVENUE, LAWRENCEBURG, TN 38464
(931) 762-6571
Mailing address
PO BOX 440013, NASHVILLE, TN 37244-0013
(615) 620-2320
(615) 620-2323
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01036192
AMERIGROUP TENNCARE
TN
05
—
3717358(CRNA)
—
TN
05
—
3717359(MD)
—
TN
01
—
4064865
BCBS OF TN , P,S,BLUE SELECT TENNCARE
TN
Enumeration date
01/26/2007
Last updated
05/11/2010
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