| Skyridge Clinical Associates, Llc | |
|
1060 Peerless Crossing Ste 200 Cleveland TN 37312-3861 | |
| (423) 479-4165 | |
| Not Available |
| Full Name | Skyridge Clinical Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1060 Peerless Crossing, Cleveland, Tennessee |
| Authorized Official Name and Position | Garvin Kent Chastain (PRESIDENT) |
| Authorized Official Contact | 4234794165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Skyridge Clinical Associates, Llc 1060 Peerless Crossing Ste 200 Cleveland TN 37312-3861 Ph: () - | Skyridge Clinical Associates, Llc 1060 Peerless Crossing Ste 200 Cleveland TN 37312-3861 Ph: (423) 479-4165 |
| NPI Number | 1184728347 |
|---|---|
| Provider Enumeration Date | 09/11/2006 |
| Last Update Date | 08/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184728347 | NPI | - | NPPES |
| 30150621 | Medicaid | TN | |
| 4173087 | Other | TN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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