MEDICARE: CHRISTOPHER P BEARDSLEY CPO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1245486844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER P BEARDSLEY CPO

Provider Business Mailing Address
First Line	:	3700 BRAINERD RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37411-3603
Country	:	US
Telephone Number	:	423-697-0057
Fax Number	:	423-648-9366

Provider Business Practice Location Address
First Line	:	3700 BRAINERD RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37411-3603
Country	:	US
Telephone Number	:	423-697-0057
Fax Number	:	423-648-9366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	09/07/2011

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