Basic Information
| Provider Information | |||||||||
| NPI: | 1194949792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODELA | ||||||||
| FirstName: | ELAINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3570 KEITH STREET NW | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373124309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234735038 | ||||||||
| FaxNumber: | 4233394833 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800A ROSSVILLE AVE | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374081912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235316555 | ||||||||
| FaxNumber: | 4235316565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 08/20/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | 38022 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
No ID Information.