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General NPI Number Information
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NPI Number | 1750592689
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Entity Type | Organization
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Legal Business Name | PEDIATRIC HEALTH CARE ASSOCIATES, PC
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 3300 WILCOX BLVD
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City | CHATTANOOGA
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State | TN
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Zip | 37411-1073
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Country | US
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Telephone | 423-493-2100
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Fax | 423-493-2148
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Provider Business Mailing Address
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Address Line | 3300 WILCOX BLVD
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City | CHATTANOOGA
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State | TN
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Zip | 37411-1073
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Country | US
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Telephone | 423-493-2100
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Fax | 423-493-2148
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Authorized Official
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Title or Position | PEDIATRICIAN/OWNER
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Name | WILLIE MAE HUBBARD
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Credential | MD
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Telephone | 423-493-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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