Organization
CLARKSVILLE ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL T MITCHELL (BUSINESS MANAGER)
(843) 651-2624
Entity
Organization
Contact information
Practice address
132 HILLCREST DR, CLARKSVILLE, TN 37043-5000
(931) 552-0180
(931) 572-0915
Mailing address
PO BOX 4860, MURRELLS INLET, SC 29576-2698
(843) 651-2624
(843) 357-4940
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
04/09/2010
Last updated
08/19/2010
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