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General NPI Number Information
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NPI Number | 1417526971
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Entity Type | Organization
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Legal Business Name | EVERGOLD PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 06/20/2021
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Last Update Date | 06/20/2021
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Provider Practice Location Address
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Address Line | 7739 E BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-5902
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Country | US
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Telephone | 423-254-0447
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Fax |
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Provider Business Mailing Address
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Address Line | 2288 GUNBARREL RD STE 154-179
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2609
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Country | US
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Telephone | 423-254-0447
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FARHAD AHMAD AMANI
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Credential | DO
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Telephone | 423-254-0447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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