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General NPI Number Information
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NPI Number | 1003280462
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Entity Type | Organization
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Legal Business Name | JOHN CHROSTOWSKI, MD,PLLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 2158 NORTHGATE PARK LN SUITE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6911
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Country | US
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Telephone | 423-803-2460
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Fax | 423-803-2461
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Provider Business Mailing Address
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Address Line | PO BOX 11410
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City | CHATTANOOGA
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State | TN
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Zip | 37401-2410
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Country | US
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Telephone | 423-541-6658
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Fax | 423-629-0755
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | LISA CRUZ
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Credential |
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Telephone | 423-541-6658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 27877
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License Number State | TN
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