Basic Information
Provider Information
NPI: 1225167307
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAISER
FirstName: WENDY
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3549
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374040549
CountryCode: US
TelephoneNumber: 4236983309
FaxNumber: 4236246355
Practice Location
Address1: 2341 MCCALLIE AVE
Address2: SUITE 402
City: CHATTANOOGA
State: TN
PostalCode: 374043239
CountryCode: US
TelephoneNumber: 4236983309
FaxNumber: 4236246355
Other Information
ProviderEnumerationDate: 03/05/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD41760TNY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home