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General NPI Number Information
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NPI Number | 1124383393
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Entity Type | Organization
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Legal Business Name | RETINA SPECIALISTS OF TENNESSEE PLLC
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Dates
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Enumeration Date | 07/12/2012
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 979 E 3RD ST SUITE 230
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2136
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Country | US
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Telephone | 423-521-2820
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Fax | 423-602-5594
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Provider Business Mailing Address
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Address Line | 979 E 3RD ST SUITE 230
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2136
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Country | US
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Telephone | 423-521-2820
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Fax | 423-602-5594
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHARON JEAN LINEBERRY
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Credential |
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Telephone | 423-521-2820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 45994
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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