Healthcare Provider Details

I. General information

NPI: 1598767444
Provider Name (Legal Business Name): CHRISTOPHER D PRATER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LEE PARKWAY DR SUITE A
CHATTANOOGA TN
37421-6708
US

IV. Provider business mailing address

105 LEE PARKWAY DR SUITE A
CHATTANOOGA TN
37421-6708
US

V. Phone/Fax

Practice location:
  • Phone: 423-305-1508
  • Fax: 423-305-1514
Mailing address:
  • Phone: 423-305-1508
  • Fax: 423-305-1514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTN8547
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberTN8547
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberTN8547
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberTN8547
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: