Provider Demographics
NPI:1871979781
Name:ANESTHESIA ASSOCIATES OF COLUMBIA TN LLC
Entity type:Organization
Organization Name:ANESTHESIA ASSOCIATES OF COLUMBIA TN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF LLC
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CLENDENIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:1A BURTON HILLS BLVD
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6187
Mailing Address - Country:US
Mailing Address - Phone:615-240-3809
Mailing Address - Fax:615-234-1809
Practice Address - Street 1:1510 1/2 HATCHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4825
Practice Address - Country:US
Practice Address - Phone:931-381-7818
Practice Address - Fax:931-381-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty