Healthcare Provider Details

I. General information

NPI: 1326887928
Provider Name (Legal Business Name): ADVANCED HYPERBARIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5864 HIGHWAY 153 SUITE 100
HIXSON TN
37343
US

IV. Provider business mailing address

5864 HIGHWAY 153 SUITE 100
HIXSON TN
37343
US

V. Phone/Fax

Practice location:
  • Phone: 423-486-0010
  • Fax:
Mailing address:
  • Phone: 423-486-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS HERRIN
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential:
Phone: 423-825-4268