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General NPI Number Information
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NPI Number | 1619056462
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Entity Type | Organization
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Legal Business Name | STEPHEN V DRESKIN MD PC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 6130 SHALLOWFORD RD STE 101
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7222
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Country | US
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Telephone | 423-664-4635
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Fax | 423-664-4640
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Provider Business Mailing Address
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Address Line | 6130 SHALLOWFORD RD STE 101
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7222
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Country | US
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Telephone | 423-664-4635
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Fax | 423-664-4640
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Authorized Official
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Title or Position | MANAGER
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Name | AMBER GENTER
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Credential |
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Telephone | 423-664-4635
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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 | 26298
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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 | 26240
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 846
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11764
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN8476
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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