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NPI Code Detail

MEDICARE: CHATTANOOGA FOOT SPECIALISTS, PLLC

MEDICARE: CHATTANOOGA FOOT SPECIALISTS, PLLC
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
1213ES0103XFoot & Ankle Surgery Podiatrist590TN

General Provider Information

NPI Number : 1487747457
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHATTANOOGA FOOT SPECIALISTS, PLLC
Provider Business Mailing Address
First Line : 2707 CITICO AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37406-3402
Country : US
Telephone Number : 423-698-4899
Fax Number : 423-698-8269
Provider Business Practice Location Address
First Line : 2707 CITICO AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37406-3402
Country : US
Telephone Number : 843-628-0023
Fax Number : 423-698-8269
Authorized Official
Title or Position : PRACTICE OWNER
Name : LISA WAMACK
Credential : DPM
Telephone Number : 423-698-4899
Provider Enumeration Date : 10/02/2006
Last Update Date : 04/07/2023

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Directions to “CHATTANOOGA FOOT SPECIALISTS, PLLC ” Practice Location

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