1194736108 NPI number — INTEGRATED ANESTHESIA SERVICES, PLC

Table of content: DR. THOMAS MARK ZURKOWSKI M.D. (NPI 1477617918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194736108 NPI number — INTEGRATED ANESTHESIA SERVICES, PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRATED ANESTHESIA SERVICES, PLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194736108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 291264
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37229-1264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-620-2320
Provider Business Mailing Address Fax Number:
615-620-2323

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
704 HIGHWAY 70 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DICKSON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37055-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-620-2320
Provider Business Practice Location Address Fax Number:
615-620-2323
Provider Enumeration Date:
08/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STEANSON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-620-2320

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1518169 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4129307 . This is a "BLUE CROSS/BLUE SHIELD OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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