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General NPI Number Information
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NPI Number | 1902914237
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA BARIATRICS, PLLC
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 7405 SHALLOWFORD RD STE 160
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2662
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Country | US
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Telephone | 423-899-1000
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Fax | 423-899-9824
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Provider Business Mailing Address
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Address Line | PO BOX 1969
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City | DALTON
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State | GA
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Zip | 30722-1969
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Country | US
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Telephone | 706-278-6403
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Fax | 706-278-0087
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. WANDA B HOLT
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Credential |
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Telephone | 706-278-6403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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