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NPI Code Detail

MEDICARE: DR. WILLIAM TODD HARTLEY M.D.

MEDICARE: DR. WILLIAM TODD HARTLEY 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
1174400000XSpecialistMD38313TN
2207X00000XOrthopaedic Surgery PhysicianMD38313TN

General Provider Information

NPI Number : 1770582975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM TODD HARTLEY M.D.
Provider Business Mailing Address
First Line : 2415 MCCALLIE AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-3322
Country : US
Telephone Number : 423-624-2696
Fax Number : 423-697-2055
Provider Business Practice Location Address
First Line : 2415 MCCALLIE AVE
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37404-3322
Country : US
Telephone Number : 423-624-2696
Fax Number : 423-697-2055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 11/07/2012

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