MEDICARE: MARK T POLLARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	MD20905	TN

General Provider Information

NPI Number	:	1942231139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK T POLLARD MD

Provider Business Mailing Address
First Line	:	6170 SHALLOWFORD RD
Second Line	:	STE 101
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-1892
Country	:	US
Telephone Number	:	423-648-4500
Fax Number	:	423-648-8117

Provider Business Practice Location Address
First Line	:	1494 STUART RD NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-5823
Country	:	US
Telephone Number	:	423-648-7699
Fax Number	:	423-648-7695

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	03/05/2008

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