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Organization

AMERICAN ANESTHESIOLOGY GROUP OF TENNESSEE, P. C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRANCIS ABDOU MD (AUTHORIZED OFFICIAL)
(423) 224-3460
Entity
Organization

Contact information

Practice address
135 W RAVINE RD, STE 5-B, KINGSPORT, TN 37660-3847
(423) 224-3460
(423) 224-3465
Mailing address
135 W RAVINE RD STE 5-B, KINGSPORT, TN 37660-3847
(423) 224-3460
(423) 224-3465

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1374528
AAG BENEFIT PLAN ADMIN
05
3701197
TN
01
373565800
US DEPT OF LABOR-OWCP
01
7490409500
MEDICAID
KY
05
89020P
NC
01
CB1389
RAILROAD MEDICARE
Enumeration date
07/26/2005
Last updated
12/20/2019
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