Basic Information
| Provider Information | |||||||||
| NPI: | 1720379829 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHATFIELD | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | KENNETH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 ERLANGER SOUTH DR | ||||||||
| Address2: | |||||||||
| City: | RINGGOLD | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307363179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237782900 | ||||||||
| FaxNumber: | 7069377207 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 ERLANGER SOUTH DR | ||||||||
| Address2: | |||||||||
| City: | RINGGOLD | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237782900 | ||||||||
| FaxNumber: | 7069377207 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2011 | ||||||||
| LastUpdateDate: | 08/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 57728 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | 57728 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207QS0010X | 074328 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | 074328 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.