Healthcare Provider Details
I. General information
NPI: 1881904555
Provider Name (Legal Business Name): CHATTANOOGA FOOT & ANKLE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2010
Last Update Date: 03/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 N HOLTZCLAW AVE SUITE 210
CHATTANOOGA TN
37404
US
IV. Provider business mailing address
5251 HIGHWAY 153 STE C #137
HIXSON TN
37343-4959
US
V. Phone/Fax
- Phone: 423-698-2406
- Fax: 423-698-1667
- Phone: 423-698-2406
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARLENE
JOY
PICKETT
Title or Position: CEO
Credential:
Phone: 423-698-2406