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NPI Code Detail

MEDICARE: DR. MARK C THEL MD

MEDICARE: DR. MARK C THEL MD
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
1207RC0000XCardiovascular Disease Physician33842TN
2207RI0011XInterventional Cardiology Physician33842TN

General Provider Information

NPI Number : 1659370997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK C THEL MD
Provider Business Mailing Address
First Line : 2501 CITICO AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-1127
Country : US
Telephone Number : 423-697-2000
Fax Number : 423-697-2118
Provider Business Practice Location Address
First Line : 2501 CITICO AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-1127
Country : US
Telephone Number : 423-697-2000
Fax Number : 423-697-2118
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 09/12/2019

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