Basic Information
| Provider Information | |||||||||
| NPI: | 1184052722 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEARTH MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800A ROSSVILLE AVE | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374081912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235316555 | ||||||||
| FaxNumber: | 4235316565 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800A ROSSVILLE AVE | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374081912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235316555 | ||||||||
| FaxNumber: | 4235316565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2013 | ||||||||
| LastUpdateDate: | 10/16/2013 | ||||||||
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| AuthorizedOfficialLastName: | DUNCAN | ||||||||
| AuthorizedOfficialFirstName: | DEANNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 4232800433 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | MD0000029730 | TN | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.