Basic Information
| Provider Information | |||||||||
| NPI: | 1407180508 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY | ||||||||
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| OtherOrganizationName: | ACADEMIC ENDOCRINOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11589 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374012589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237788179 | ||||||||
| FaxNumber: | 4237788180 | ||||||||
| Practice Location | |||||||||
| Address1: | 979 E 3RD ST | ||||||||
| Address2: | SUITE B-601 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374032136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237788179 | ||||||||
| FaxNumber: | 4237788180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2009 | ||||||||
| LastUpdateDate: | 09/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | SWAFFORD | ||||||||
| AuthorizedOfficialFirstName: | CATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4237784044 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.