Healthcare Provider Details

I. General information

NPI: 1972520963
Provider Name (Legal Business Name): UNIVERSITY SURGICAL ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 E 3RD ST SUITE 300
CHATTANOOGA TN
37403-2136
US

IV. Provider business mailing address

979 E 3RD ST STE 300
CHATTANOOGA TN
37403-2187
US

V. Phone/Fax

Practice location:
  • Phone: 423-267-0466
  • Fax: 423-757-0770
Mailing address:
  • Phone: 423-267-0466
  • Fax: 423-757-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN W. DART
Title or Position: PRESIDENT
Credential: M.D.
Phone: 423-267-0466