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General NPI Number Information
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NPI Number | 1205143187
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Entity Type | Individual
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Provider Name | JOHN STEWART CARDEN PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 3372 KEITH ST NW
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City | CLEVELAND
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State | TN
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Zip | 37312-3718
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Country | US
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Telephone | 423-476-4751
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Fax | 423-339-2692
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Provider Business Mailing Address
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Address Line | 2372 LIFESTYLE WAY STE 152
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4940
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Country | US
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Telephone | 423-894-0432
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Fax | 423-894-0475
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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