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General NPI Number Information
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NPI Number | 1063451813
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Entity Type | Individual
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Provider Name | SUSAN P RASCHAL D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 1350 MACKEY BRANCH DR SUITE 114
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3482
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Country | US
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Telephone | 423-468-3267
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Fax | 423-468-3270
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Provider Business Mailing Address
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Address Line | 9800 SHELBYVILLE RD STE 220
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City | LOUISVILLE
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State | KY
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Zip | 40223-2992
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Country | US
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Telephone | 502-429-8585
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Fax | 855-656-7325
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | DO01251
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 044989
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License Number State | GA
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