Basic Information
| Provider Information | |||||||||
| NPI: | 1114466075 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHATTANOOGA HEART AND RHYTHM CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5751 UPTAIN RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374114077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234243695 | ||||||||
| FaxNumber: | 4234243690 | ||||||||
| Practice Location | |||||||||
| Address1: | 5243 LITTLE DEBBIE PARKWAY | ||||||||
| Address2: | STE 111 | ||||||||
| City: | OOLTEWAH | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234243695 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2017 | ||||||||
| LastUpdateDate: | 02/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | COOPER | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4235054916 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.