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General NPI Number Information
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NPI Number | 1447205182
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Entity Type | Organization
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Legal Business Name | BEACON HEALTH ALLIANCE PC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 725 GLENWOOD DR SUITE 480E
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1163
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Country | US
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Telephone | 423-756-5779
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Fax | 423-242-4552
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Provider Business Mailing Address
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Address Line | 725 GLENWOOD DR SUITE 480E
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1163
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Country | US
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Telephone | 423-756-5779
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Fax | 423-242-4552
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. COLLIN G CHERRY
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Credential |
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Telephone | 423-756-5779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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