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General NPI Number Information
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NPI Number | 1619461605
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Entity Type | Organization
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Legal Business Name | OPERATIVE MONITORING OF SOUTHEAST TENNESSEE
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 200 W. MLK BLVD SUITE 1000 (10TH FLOOR)
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City | CHATTANOOGA
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State | TN
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Zip | 37402
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Country | US
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Telephone | 423-903-3112
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W. MLK BLVD SUITE 1000 (10TH FLOOR)
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City | CHATTANOOGA
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State | TN
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Zip | 37402
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Country | US
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Telephone | 423-903-3112
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRUCE KAPLAN
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Credential | MD
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Telephone | 423-718-1842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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