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General NPI Number Information
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NPI Number | 1548203821
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA ORTHOPAEDIC GROUP PC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 2415 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3322
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Country | US
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Telephone | 423-624-2696
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Fax | 423-622-6249
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Provider Business Mailing Address
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Address Line | 2415 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3322
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Country | US
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Telephone | 423-624-2696
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Fax | 423-622-6249
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MS. REBECCA BURNETT
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Credential |
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Telephone | 423-624-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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