Healthcare Provider Details

I. General information

NPI: 1124260575
Provider Name (Legal Business Name): STEVEN K CHASE D.P.M. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7174 US HIGHWAY 64 123
BARTLETT TN
38133-8954
US

IV. Provider business mailing address

7174 US HIGHWAY 64 123
BARTLETT TN
38133-8954
US

V. Phone/Fax

Practice location:
  • Phone: 901-386-0525
  • Fax: 901-386-0500
Mailing address:
  • Phone: 901-386-0525
  • Fax: 901-386-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number126
License Number StateTN

VIII. Authorized Official

Name: STEVEN K CHASE
Title or Position: PRESIDENT
Credential: DPM
Phone: 901-386-0525