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General NPI Number Information
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NPI Number | 1932572575
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA ORTHOPAEDIC GROUP, PC
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 24 MOUNTAIN VIEW DR SUITE A
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City | KIMBALL
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State | TN
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Zip | 37347-5477
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Country | US
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Telephone | 423-624-2696
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3322
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Country | US
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Telephone | 423-624-2696
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BECKY FARMER
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Credential |
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Telephone | 423-624-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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