Organization
ATHENS ANESTHESIA ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL E LONG CRNA (PRESIDENT)
(423) 424-3695
Entity
Organization
Contact information
Practice address
1114 W MADISON AVE, ATHENS, TN 37303-4150
(423) 745-1411
Mailing address
PO BOX 220, ATHENS, TN 37371-0220
(423) 424-3695
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3734665
—
TN
01
—
DF1630
RR MEDICARE
—
Enumeration date
05/10/2006
Last updated
10/30/2007
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