Healthcare Provider Details

I. General information

NPI: 1023178787
Provider Name (Legal Business Name): CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 WHEELERTOWN AVENUE
PIKEVILLE TN
37367
US

IV. Provider business mailing address

PO BOX 11226
CHATTANOOGA TN
37401
US

V. Phone/Fax

Practice location:
  • Phone: 423-447-2112
  • Fax: 423-447-6971
Mailing address:
  • Phone: 423-778-3274
  • Fax: 423-778-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN COBB
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 423-778-5445