Organization
KINGSPORT ANESTHESIA, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORNA K EHRENFRIED M.D. (OWNER)
(423) 854-0001
Entity
Organization
Contact information
Practice address
302 WESLEY ST STE 3, JOHNSON CITY, TN 37601-1741
(423) 283-7302
Mailing address
3101 BROWNS MILL RD STE 6 PMB 386, JOHNSON CITY, TN 37604-4100
(423) 854-0001
(423) 854-0002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000034445
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3856308
—
TN
01
—
4067843
BCBS TN PROVIDER NUMBER
TN
Enumeration date
08/31/2006
Last updated
08/22/2020
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