Healthcare Provider Details

I. General information

NPI: 1831146356
Provider Name (Legal Business Name): CHATTANOOGA GYN-ONCOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2006
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E 3RD ST SUITE 201
CHATTANOOGA TN
37403-2106
US

IV. Provider business mailing address

PO BOX 867
OOLTEWAH TN
37363-0867
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-2050
  • Fax: 423-698-2095
Mailing address:
  • Phone: 423-698-2050
  • Fax: 423-698-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD HEASTON CHAMBERLAIN
Title or Position: MEMBER
Credential: M.D.
Phone: 423-698-2050