Healthcare Provider Details

I. General information

NPI: 1255755575
Provider Name (Legal Business Name): ALEXANDER SIKES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 SPRING CREEK RD EMERGENCY DEPARTMENT
CHATTANOOGA TN
37412-3909
US

IV. Provider business mailing address

941 SPRING CREEK RD EMERGENCY DEPARTMENT
CHATTANOOGA TN
37412-3909
US

V. Phone/Fax

Practice location:
  • Phone: 423-894-7870
  • Fax:
Mailing address:
  • Phone: 423-894-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number54006
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: