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721 Glenwood Dr Suite W473 Chattanooga TN 37404-1106 | |
| (423) 495-4730 | |
| (423) 495-4733 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 721 Glenwood Dr, Chattanooga, Tennessee |
| Authorized Official Name and Position | Carolyn F. Nelson (PRACTICE MANAGER) |
| Authorized Official Contact | 4234954730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
721 Glenwood Dr Suite W473 Chattanooga TN 37404-1106 Ph: (423) 495-4730 | 721 Glenwood Dr Suite W473 Chattanooga TN 37404-1106 Ph: (423) 495-4730 |
| NPI Number | 1740339936 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740339936 | NPI | - | NPPES |
| 3731329 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Tennessee) | Primary |
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