Healthcare Provider Details

I. General information

NPI: 1659735298
Provider Name (Legal Business Name): CHASE ESCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2016
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4588 CAROTHERS PKWY
FRANKLIN TN
37067-6577
US

IV. Provider business mailing address

1364 CLIFTON RD NE
ATLANTA GA
30322-1059
US

V. Phone/Fax

Practice location:
  • Phone: 615-716-4747
  • Fax: 615-716-4085
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number62939
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: