Provider Demographics
NPI:1386609394
Name:SCHLABACH, LARRY L (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:L
Last Name:SCHLABACH
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:PO BOX 440100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0100
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:615-329-0579
Practice Address - Street 1:1032 MCCALLIE AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2836
Practice Address - Country:US
Practice Address - Phone:423-752-5004
Practice Address - Fax:423-414-3834
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00019043207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD00019043OtherLICENSE
TN3052363Medicaid
TN3052363Medicaid
3052369Medicare ID - Type Unspecified
E43146Medicare UPIN