Healthcare Provider Details

I. General information

NPI: 1730259615
Provider Name (Legal Business Name): TRI STATE PSYCHIATRIC SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6918 SHALLOWFORD RD SUITE 200
CHATTANOOGA TN
37421
US

IV. Provider business mailing address

6918 SHALLOWFORD RD SUITE 200
CHATTANOOGA TN
37421
US

V. Phone/Fax

Practice location:
  • Phone: 423-499-6165
  • Fax: 423-499-0693
Mailing address:
  • Phone: 423-499-6165
  • Fax: 423-499-0693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD022212
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD022212
License Number StateTN

VIII. Authorized Official

Name: MR. RAMESH C APPAREDDY
Title or Position: SECRETARY OF CORPORATION
Credential:
Phone: 423-505-4693