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General NPI Number Information
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NPI Number | 1285048900
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Entity Type | Organization
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Legal Business Name | EMBRYO SERVICES LLC
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 06/20/2014
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Provider Practice Location Address
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Address Line | 7407 ZIEGLER RD SUITE B
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3157
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Country | US
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Telephone | 423-899-0500
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Fax | 423-899-2411
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Provider Business Mailing Address
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Address Line | 7407 ZIEGLER RD SUITE B
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City | CHATTANOOGA
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State | TN
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Zip | 37421-3157
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Country | US
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Telephone | 423-899-0500
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Fax | 423-899-2411
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Authorized Official
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Title or Position | MEMBER
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Name | DR. BARRY DONESKY
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Credential | MD
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Telephone | 423-899-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD21612
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD25468
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License Number State | TN
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