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General NPI Number Information
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NPI Number | 1013026020
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Entity Type | Organization
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Legal Business Name | SPRING CREEK PEDIATRICS, INC.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 929 SPRING CREEK RD SUITE 206
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City | CHATTANOOGA
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State | TN
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Zip | 37412-3964
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Country | US
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Telephone | 423-892-3400
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Fax | 423-892-8266
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Provider Business Mailing Address
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Address Line | 929 SPRING CREEK RD SUITE 206
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City | CHATTANOOGA
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State | TN
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Zip | 37412-3964
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Country | US
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Telephone | 423-892-3400
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Fax | 423-892-8266
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHANIE A STEGALL
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Credential | M.D.
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Telephone | 423-892-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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