Provider Demographics
NPI:1336197987
Name:CHASE, CHRISTOPHER W (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:CHASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5079
Mailing Address - Country:US
Mailing Address - Phone:423-624-0021
Mailing Address - Fax:423-624-5258
Practice Address - Street 1:3404 NAVAJO DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5079
Practice Address - Country:US
Practice Address - Phone:423-624-0021
Practice Address - Fax:423-624-5258
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24780208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H10925Medicare UPIN
TN3853980Medicare ID - Type Unspecified