1518923705 NPI number — ANESTHESIOLOGISTS ASSOCIATED PC

Table of content: SUZANNA FRYE M.ED., BCBA (NPI 1154838324)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518923705 NPI number — ANESTHESIOLOGISTS ASSOCIATED PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIOLOGISTS ASSOCIATED PC
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:
1518923705
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3549
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37404-0549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-598-3309
Provider Business Mailing Address Fax Number:
423-624-6355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2341 MCCALLIE AVE
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37404-3239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-598-3309
Provider Business Practice Location Address Fax Number:
423-624-6355
Provider Enumeration Date:
04/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCGRAW
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
423-698-3309

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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