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General NPI Number Information
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NPI Number | 1124464995
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Entity Type | Organization
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Legal Business Name | ALLIED PEDIATRICS PLLC
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 7405 SHALLOWFORD RD SUITE 270
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2661
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Country | US
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Telephone | 423-602-9545
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Fax | 423-602-9546
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Provider Business Mailing Address
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Address Line | 7405 SHALLOWFORD RD SUITE 270
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2661
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Country | US
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Telephone | 423-602-9545
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Fax | 423-602-9546
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Authorized Official
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Title or Position | OWNER
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Name | DELIA A WESSELS-ANDERSON
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Credential |
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Telephone | 775-881-8984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 49755
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License Number State | TN
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