Organization
MEDICAL CENTER ANESTHESIA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BART TEAGUE (EXECUTIVE DIRECTOR OF PFS)
(833) 500-9913
Entity
Organization
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(833) 500-9913
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(800) 242-1131
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/12/2013
Last updated
06/10/2020
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