Healthcare Provider Details

I. General information

NPI: 1780175596
Provider Name (Legal Business Name): BENJAMIN SCOTT HARRINGTON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

1949 GUNBARREL RD STE 206
CHATTANOOGA TN
37421-7133
US

V. Phone/Fax

Practice location:
  • Phone: 234-957-4044
  • Fax: 423-495-2625
Mailing address:
  • Phone: 423-495-7404
  • Fax: 423-495-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL51975
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: