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General NPI Number Information
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NPI Number | 1205208352
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Entity Type | Organization
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Legal Business Name | VASCULAR INSTITUTE OF CHATTANOOGA, PLLC
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 2358 LIFESTYLE WAY STE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4907
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Country | US
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Telephone | 423-602-2750
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Fax | 423-602-2762
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Provider Business Mailing Address
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Address Line | 2358 LIFESTYLE WAY STE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4907
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Country | US
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Telephone | 423-602-2750
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Fax | 423-602-2762
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Authorized Official
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Title or Position | ORGANIZER
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Name | DR. CHRISTOPHER J LESAR
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Credential | M.D.
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Telephone | 423-602-2750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MD37354
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License Number State | TN
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