Healthcare Provider Details

I. General information

NPI: 1245868330
Provider Name (Legal Business Name): CYNTHIA TOUGHLIAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

PO BOX 116638
ATLANTA GA
30368-6638
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-7404
  • Fax: 423-495-2625
Mailing address:
  • Phone: 423-495-8659
  • Fax: 423-495-4974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number5337
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: