Bryn Medical Center | |
6221 Shallowford Rd Ste 100 Chattanooga TN 37421-1972 | |
(423) 541-9455 | |
Not Available |
Full Name | Bryn Medical Center |
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Speciality | General Practice |
Location | 6221 Shallowford Rd Ste 100, Chattanooga, Tennessee |
Authorized Official Name and Position | Candice Crawford (OWNER) |
Authorized Official Contact | 4048394566 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bryn Medical Center 2854 Amsterdam Ln Chattanooga TN 37421-1283 Ph: (404) 839-4566 | Bryn Medical Center 6221 Shallowford Rd Ste 100 Chattanooga TN 37421-1972 Ph: (423) 541-9455 |
NPI Number | 1023894623 |
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Provider Enumeration Date | 09/07/2023 |
Last Update Date | 11/01/2023 |
Medicare PECOS PAC ID | 7719337989 |
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Medicare Enrollment ID | O20231229002296 |
Identifier | Type | State | Issuer |
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1023894623 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Jessica Marie Rose |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710592035 PECOS PAC ID: 6305257510 Enrollment ID: I20201119000986 |
Provider Name | Trudie C Li |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215331913 PECOS PAC ID: 9537484472 Enrollment ID: I20221118002868 |
Provider Name | Candice Alisha Crawford |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1700133394 PECOS PAC ID: 2062881790 Enrollment ID: I20221219002838 |
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