Healthcare Provider Details
I. General information
NPI: 1124074596
Provider Name (Legal Business Name): ASSOCIATES IN PLASTIC AND RECONSTRUCTIVE SURGERY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3404 NAVAJO DR
CHATTANOOGA TN
37411-5079
US
IV. Provider business mailing address
3404 NAVAJO DR
CHATTANOOGA TN
37411-5079
US
V. Phone/Fax
- Phone: 423-624-0021
- Fax: 423-624-5258
- Phone: 423-624-0021
- Fax: 423-624-5258
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
CHASE
Title or Position: PRESIDENT
Credential: MD
Phone: 423-624-0021