Basic Information
Provider Information
NPI: 1326487257
EntityType: 2
ReplacementNPI:  
OrganizationName: CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UT ERLANGER HEALTH & WELLNESS-SIGNAL MOUNTAIN
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 11589
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374012589
CountryCode: US
TelephoneNumber: 4237783274
FaxNumber: 4237784664
Practice Location
Address1: 2600 TAFT HWY
Address2:  
City: SIGNAL MOUNTAIN
State: TN
PostalCode: 373772774
CountryCode: US
TelephoneNumber: 4237789434
FaxNumber: 4237789433
Other Information
ProviderEnumerationDate: 06/25/2013
LastUpdateDate: 06/25/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SWAFFORD
AuthorizedOfficialFirstName: CATHY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 4237784044
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home