Organization
SMOKEY MOUNTAIN ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES ROOT CRNA (MANAGING PARTNER)
(423) 967-3436
Entity
Organization
Contact information
Practice address
110 MED TECH PKWY, JOHNSON CITY, TN 37604-4004
(423) 722-0371
Mailing address
PO BOX 5665, JOHNSON CITY, TN 37602-5665
(423) 639-0941
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3723481
—
TN
Enumeration date
06/26/2006
Last updated
01/11/2022
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