Organization
PREMIER ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRYL FONTAINE M.D. (PRESIDENT)
(423) 239-5833
Entity
Organization
Contact information
Practice address
2000 BROOKSIDE DRIVE, SUITE 207, KINGSPORT, TN 37660-4627
(423) 239-5833
(423) 239-9789
Mailing address
P.O. BOX 3409, SUITE 207, KINGSPORT, TN 37664-0409
(423) 239-5833
(423) 239-9789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
06/10/2011
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