Provider Demographics
NPI:1194087833
Name:ARRHYTHMIA AND CARDIOLOGY OF CHATTANOOGA
Entity type:Organization
Organization Name:ARRHYTHMIA AND CARDIOLOGY OF CHATTANOOGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERSHON
Authorized Official - Middle Name:YEHUDA
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-778-7156
Mailing Address - Street 1:PO BOX 21731
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37424-0731
Mailing Address - Country:US
Mailing Address - Phone:423-778-7156
Mailing Address - Fax:423-634-8050
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE A 350
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-778-7156
Practice Address - Fax:423-634-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 26032174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNE84602Medicare UPIN