Organization
TENNESSEE VALLEY ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J FAHEY CRNA (CHIEF MANAGER)
(423) 618-3448
Entity
Organization
Contact information
Practice address
105 N MEADOWS DR, ATHENS, TN 37303-4172
(423) 649-3330
Mailing address
5483 W WATERS AVE STE 1200, TAMPA, FL 33634-1236
(813) 287-5718
(813) 287-5728
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3729421
—
TN
01
—
DD2592
RAILROAD MEDICARE GROUP
TN
Enumeration date
05/17/2006
Last updated
06/18/2019
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