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General NPI Number Information
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NPI Number | 1619949666
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Entity Type | Organization
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Legal Business Name | CNTR FOR DIGESTIVE DISORDERS & CLINICAL REASEARCH
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2341 MCCALLIE AVENUE PLAZA 3 SUITE 201
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City | CHATTANOOGA
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State | TN
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Zip | 37404
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Country | US
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Telephone | 423-698-0254
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Fax | 423-698-4762
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Provider Business Mailing Address
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Address Line | 2341 MCCALLIE AVENUE PLAZA 3 SUITE 201
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City | CHATTANOOGA
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State | TN
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Zip | 37404
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Country | US
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Telephone | 423-698-0254
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Fax | 423-698-4762
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATER
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Name | MRS. TARA S HILL
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Credential |
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Telephone | 423-698-0254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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