Basic Information
Provider Information
NPI: 1477842193
EntityType: 2
ReplacementNPI:  
OrganizationName: CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ERLANGER SURGICAL WEIGHT LOSS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 11231
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374012231
CountryCode: US
TelephoneNumber: 4237783274
FaxNumber: 4237782255
Practice Location
Address1: 979 EAST THIRD STREET
Address2: SUITE # C-620
City: CHATTANOOGA
State: TN
PostalCode: 37403
CountryCode: US
TelephoneNumber: 4237782906
FaxNumber: 4237789497
Other Information
ProviderEnumerationDate: 04/04/2011
LastUpdateDate: 07/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SWAFFORD
AuthorizedOfficialFirstName: CATHY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 4237784044
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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