Organization
LONGVIEW REGIONAL HOSPITAL-BASED PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY MUSIC (DIRECTOR, PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
2901 4TH ST, LONGVIEW, TX 75605-5128
(903) 758-1818
(903) 381-7293
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7380
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
12/21/2023
Last updated
12/27/2023
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