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General NPI Number Information
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NPI Number | 1477546885
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Entity Type | Individual
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Provider Name | JOHN ALLEN GRACY MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 7011 SHALLOWFORD RD SUITE 106
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6727
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Country | US
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Telephone | 423-826-8585
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Fax | 423-826-8588
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Provider Business Mailing Address
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Address Line | PO BOX 430
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City | CHATTANOOGA
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State | TN
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Zip | 37401-0430
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Country | US
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Telephone | 423-826-8585
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Fax | 423-826-8588
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20422
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 27446
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 034145
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0101271210
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License Number State | VA
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