Healthcare Provider Details

I. General information

NPI: 1043632433
Provider Name (Legal Business Name): TENNESSEE INTERVENTIONAL AND IMAGING ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2014
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST BOX 376
CHATTANOOGA TN
37403-2147
US

IV. Provider business mailing address

975 E 3RD ST BOX 376
CHATTANOOGA TN
37403-2147
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-7234
  • Fax:
Mailing address:
  • Phone: 423-778-7234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: STEVE JOHNSON
Title or Position: CEO
Credential:
Phone: 423-778-7234