Basic Information
| Provider Information | |||||||||
| NPI: | 1760697734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLOSE | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | DENBY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 11589 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237783274 | ||||||||
| FaxNumber: | 4237778225 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 PINEVILLE RD | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374052645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232650063 | ||||||||
| FaxNumber: | 4232651060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2007 | ||||||||
| LastUpdateDate: | 06/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 45475 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.