Healthcare Provider Details

I. General information

NPI: 1528979242
Provider Name (Legal Business Name): TWO DOC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 45TH ST NE
FORT PAYNE AL
35967-4010
US

IV. Provider business mailing address

1110 MARKET ST STE 502
CHATTANOOGA TN
37402-3310
US

V. Phone/Fax

Practice location:
  • Phone: 423-602-9530
  • Fax:
Mailing address:
  • Phone: 423-602-9530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHANA FORTENBERRY
Title or Position: ACCESS MANAGER
Credential: CMA (AAMA)
Phone: 423-463-2732