MEDICARE: JACK EWELL GREER M.D.

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	207Y00000X	Otolaryngology Physician	047438	GA
2	207Y00000X	Otolaryngology Physician	MD0000026020	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1040185	OTHER	TN	UNITED HLTHCARE
2	3126040	OTHER	TN	BC/BS TN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609875467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACK EWELL GREER M.D.

Provider Business Mailing Address
First Line	:	1604 GUNBARREL RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 RIVERFRONT PARKWAY
Second Line	:	SUITE 300
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2193
Country	:	US
Telephone Number	:	423-698-8981
Fax Number	:	423-697-7109

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	06/25/2025

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Directions to “ JACK EWELL GREER M.D.” Practice Location

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