Healthcare Provider Details

I. General information

NPI: 1437775699
Provider Name (Legal Business Name): SCENIC CITY PLASTIC SURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7161 LEE HWY STE 300
CHATTANOOGA TN
37421-8609
US

IV. Provider business mailing address

7161 LEE HWY STE 300
CHATTANOOGA TN
37421-8609
US

V. Phone/Fax

Practice location:
  • Phone: 423-418-6369
  • Fax: 615-235-1300
Mailing address:
  • Phone: 423-418-6369
  • Fax: 615-235-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CINDY MCCORD
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 423-418-6369