Organization
COASTAL MEDICAL AND ANESTHESIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB CARROLL CRNA (CEO)
(731) 926-0431
Entity
Organization
Contact information
Practice address
935 WAYNE RD, SAVANNAH, TN 38372-1904
(731) 926-8000
Mailing address
183 UNION AVE, JACKSON, TN 38301-6036
(731) 926-0431
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/07/2019
Last updated
04/07/2019
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