Provider Demographics
NPI:1972052561
Name:LINCOLN ANESTHESIA SERVICES PLLC
Entity type:Organization
Organization Name:LINCOLN ANESTHESIA SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CRNA SR PARTNER OF LAS
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LANGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:256-763-9551
Mailing Address - Street 1:PO BOX 1421
Mailing Address - Street 2:106 MEDICAL CENTER BLVD - ATTN: PATSY LANGFORD,CRNA
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-1421
Mailing Address - Country:US
Mailing Address - Phone:931-438-7594
Mailing Address - Fax:931-438-3252
Practice Address - Street 1:106 MEDICAL CENTER BLVD
Practice Address - Street 2:ATTN: PATSY A. LANGFORD, CRNA - ANESTHESIA DEPT
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-2684
Practice Address - Country:US
Practice Address - Phone:931-438-7594
Practice Address - Fax:931-438-3252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-24
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000019604367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1437139433OtherINDIVIDUAL NPI
TN1437139433OtherINDIVIDUAL NPI