Healthcare Provider Details

I. General information

NPI: 1588772545
Provider Name (Legal Business Name): OLIVER LEE GREGORY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 COURAGE WAY
CHATTANOOGA TN
37421-1555
US

IV. Provider business mailing address

7345 COURAGE WAY STE 101
CHATTANOOGA TN
37421-1555
US

V. Phone/Fax

Practice location:
  • Phone: 423-648-9290
  • Fax: 423-499-2308
Mailing address:
  • Phone: 423-602-9797
  • Fax: 423-602-9796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number19965
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number19965
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: