Healthcare Provider Details

I. General information

NPI: 1316176050
Provider Name (Legal Business Name): THOMAS E. DAVIS, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2009
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 MCCALLIE AVE
CHATTANOOGA TN
37404-3398
US

IV. Provider business mailing address

4295 CROMWELL RD STE. 308
CHATTANOOGA TN
37421-2166
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-0221
  • Fax:
Mailing address:
  • Phone: 423-877-2312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number36302
License Number StateTN

VIII. Authorized Official

Name: THOMAS E. DAVIS
Title or Position: OWNER
Credential: M.D.
Phone: 423-827-4393