Basic Information
| Provider Information | |||||||||
| NPI: | 1952379455 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHATTANOOGA ONCOLOGY AND HEMATOLOGY ASSOCIATES | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COHA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 605 GLENWOOD DRIVE | ||||||||
| Address2: | STE 200 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374041130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236981844 | ||||||||
| FaxNumber: | 4236242226 | ||||||||
| Practice Location | |||||||||
| Address1: | 605 GLENWOOD DRIVE | ||||||||
| Address2: | STE 200 | ||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374041130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236981844 | ||||||||
| FaxNumber: | 4236242226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 10/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | ARROWSMITH, M.D. | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4236981844 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 3388541 | 05 | TN | MEDICAID | CA7999 | 01 | RAILROAD MEDICARE | OTHER |