Basic Information
| Provider Information | |||||||||
| NPI: | 1063451813 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RASCHAL | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9800 SHELBYVILLE RD | ||||||||
| Address2: | STE 220 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402232992 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024298585 | ||||||||
| FaxNumber: | 8556567325 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 MACKEY BRANCH DR | ||||||||
| Address2: | SUITE 114 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374213482 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234683267 | ||||||||
| FaxNumber: | 4234683270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 04/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | DO01251 | TN | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology | 207K00000X | 044989 | GA | N | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.