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NPI Code Detail

MEDICARE: JONATHAN K CHRISTIANSON DO

MEDICARE: JONATHAN K CHRISTIANSON DO
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
12084P0800XPsychiatry PhysicianDO0000000991TN

General Provider Information

NPI Number : 1639112568
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN K CHRISTIANSON DO
Provider Business Mailing Address
First Line : 4610 BRAINERD RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37411-3835
Country : US
Telephone Number : 423-265-2271
Fax Number : 423-785-3454
Provider Business Practice Location Address
First Line : 100 MOCCASIN BEND RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37405-4415
Country : US
Telephone Number : 423-265-2271
Fax Number : 423-785-3454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 07/08/2007

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Directions to “ JONATHAN K CHRISTIANSON DO” Practice Location

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