Organization
SHELBY ANESTHESIA SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS VICKERS CRNA (PRESIDENT)
(901) 682-6828
Entity
Organization
Contact information
Practice address
6005 PARK AVE, SUITE 905 B, MEMPHIS, TN 38119-5202
(901) 682-6828
(901) 682-9316
Mailing address
PO BOX 172104, MEMPHIS, TN 38187-2104
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
08/25/2006
Last updated
11/06/2007
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