Organization
PULASKI ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CLEMENS MD, PHD (CEO)
(660) 826-5960
Entity
Organization
Contact information
Practice address
1265 E COLLEGE ST, PULASKI, TN 38478-4541
(660) 826-5960
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q021545
—
TN
Enumeration date
03/30/2016
Last updated
02/21/2020
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