Provider Demographics
NPI:1053356857
Name:MIDDLETOWN ANESTHESIA CONSULTANTS INC
Entity type:Organization
Organization Name:MIDDLETOWN ANESTHESIA CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-297-6072
Mailing Address - Street 1:PO BOX 715039
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-5039
Mailing Address - Country:US
Mailing Address - Phone:937-293-0247
Mailing Address - Fax:937-293-0960
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-2584
Practice Address - Country:US
Practice Address - Phone:513-424-2111
Practice Address - Fax:513-420-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000015081OtherANTHEM
OHCM2211OtherRAILROAD MEDICARE
OH0806793Medicaid
OH2228691Medicaid
OH=========010OtherMEDICAL MUTUAL OF OHIO
OHCM2211OtherRAILROAD MEDICARE
OH0806793Medicaid
OH2228691Medicaid
OH=========001OtherTRICARE
OH000000015081OtherANTHEM
OH=========009OtherMEDICAL MUTUAL OF OHIO
OH=========00OtherWORKERS COMPENSATION
OH=========02OtherWORKERS COMPENSATION
OH9240952Medicare ID - Type Unspecified
OHCM2211OtherRAILROAD MEDICARE