Healthcare Provider Details
I. General information
NPI: 1164359972
Provider Name (Legal Business Name): THE VEIN INSTITUTE OF CHATTANOOGA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1405 COWART ST STE 321
CHATTANOOGA TN
37408-1179
US
IV. Provider business mailing address
1405 COWART ST STE 321
CHATTANOOGA TN
37408-1179
US
V. Phone/Fax
- Phone: 423-551-8346
- Fax:
- Phone: 423-551-8346
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 202K00000X |
| Taxonomy | Phlebology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PHILLIP
KYLE
SUMMERS
Title or Position: OWNER
Credential: DO
Phone: 423-551-8346