Healthcare Provider Details
I. General information
NPI: 1063945269
Provider Name (Legal Business Name): PARKER DANIEL PLANT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/05/2017
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 E 3RD ST
CHATTANOOGA TN
37403-2101
US
IV. Provider business mailing address
900 E 3RD ST
CHATTANOOGA TN
37403-2101
US
V. Phone/Fax
- Phone: 801-907-5373
- Fax:
- Phone: 423-778-5437
- Fax: 423-778-4062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4333 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080S0010X |
| Taxonomy | Pediatric Sports Medicine Physician |
| License Number | 4333 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: