Healthcare Provider Details

I. General information

NPI: 1386765832
Provider Name (Legal Business Name): JOSEPH P SOLDO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7446 SHALLOWFORD RD STE 108
CHATTANOOGA TN
37421-2352
US

IV. Provider business mailing address

7446 SHALLOWFORD RD STE 108
CHATTANOOGA TN
37421-2352
US

V. Phone/Fax

Practice location:
  • Phone: 423-855-7376
  • Fax: 423-855-8455
Mailing address:
  • Phone: 423-855-7376
  • Fax: 423-855-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1880
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101016171
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: