Individual
MR. DAVID BLAIR COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN-CRNA
Contact information
Practice address
432 2ND STREET, NEWPORT, TN 37821-3703
(865) 777-0909
(865) 777-0910
Mailing address
12752 KINGSTON PIKE, STE E202, KNOXVILLE, TN 37934-0948
(865) 777-0909
(865) 777-0910
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
11254
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
144326
TN
367500000X
Certified Registered Nurse Anesthetist
RN144326/APN11254
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3627599
—
TN
01
—
4119264
BLUE CROSS/BLUE SHIELD
TN
01
—
P00323543
RAILROAD MEDICARE PIN
TN
Enumeration date
05/19/2006
Last updated
01/11/2011
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