Healthcare Provider Details

I. General information

NPI: 1649332859
Provider Name (Legal Business Name): JOSEPH SIMMONS BIRD JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7407 ZIEGLER ROAD
CHATTANOOGA TN
37421-3157
US

IV. Provider business mailing address

P.O. BOX 21867
CHATTANOOGA TN
37424-0867
US

V. Phone/Fax

Practice location:
  • Phone: 423-899-0500
  • Fax: 423-899-2411
Mailing address:
  • Phone: 423-899-0500
  • Fax: 423-899-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD021612
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: