Healthcare Provider Details

I. General information

NPI: 1699097790
Provider Name (Legal Business Name): RIVER CITY OB GYN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 GUNBARREL RD SUITE 209
CHATTANOOGA TN
37421-7137
US

IV. Provider business mailing address

1755 GUNBARREL RD SUITE 209
CHATTANOOGA TN
37421-7137
US

V. Phone/Fax

Practice location:
  • Phone: 423-305-7965
  • Fax: 423-305-7968
Mailing address:
  • Phone: 423-305-7965
  • Fax: 423-305-7968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number43699
License Number StateTN

VIII. Authorized Official

Name: DR. REGINA HOODS
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 423-305-7965