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General NPI Number Information
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NPI Number | 1093392151
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Entity Type | Individual
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Provider Name | DUSTIN GLENN STRICKER DO
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Gender | Male
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 2525 DESALES AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1161
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Country | US
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Telephone | 423-495-7404
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80426
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City | CHATTANOOGA
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State | TN
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Zip | 37414-7426
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Country | US
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Telephone |
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 5754
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License Number State | TN
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