| Mr Tommy Lee Fair, CRNA | |
|
200 W Tyler Ave, West Memphis, AR 72301-4223 | |
| (870) 735-1500 | |
| (870) 733-3861 |
| Full Name | Mr Tommy Lee Fair |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 200 W Tyler Ave, West Memphis, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457317828 | NPI | - | NPPES |
| 19795701 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 12971 (Tennessee) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | C00206 (Arkansas) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Tommy Lee Fair, CRNA 200 W Tyler Ave, West Memphis, AR 72301-4223 Ph: (870) 735-1500 | Mr Tommy Lee Fair, CRNA 200 W Tyler Ave, West Memphis, AR 72301-4223 Ph: (870) 735-1500 |
Jason Tibbett, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 200 Tyler St, West Memphis, AR 72301 Phone: 870-735-1500 Fax: 870-733-3861 |