Organization
LIFELINC ANESTHESIA NEVADA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY THOMPSON MD (PRESIDENT)
(901) 207-2017
Entity
Organization
Contact information
Practice address
801 E WILLIAMS AVE STE 2209, FALLON, NV 89406-3052
(901) 844-1590
(901) 844-1592
Mailing address
3340 PLAYERS CLUB PKWY STE 350, MEMPHIS, TN 38125-8949
(901) 844-1590
(901) 844-1592
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232289002
—
NV
Enumeration date
06/07/2019
Last updated
09/29/2020
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