Provider Demographics
NPI:1386751618
Name:CHASE, BARTON AUSTIN III (MD)
Entity type:Individual
Prefix:
First Name:BARTON
Middle Name:AUSTIN
Last Name:CHASE
Suffix:III
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 99
Mailing Address - Street 2:3856 HWY 57 WEST
Mailing Address - City:RAMER
Mailing Address - State:TN
Mailing Address - Zip Code:38367
Mailing Address - Country:US
Mailing Address - Phone:731-645-6118
Mailing Address - Fax:731-645-8312
Practice Address - Street 1:3856 HWY 57 WEST
Practice Address - Street 2:
Practice Address - City:RAMER
Practice Address - State:TN
Practice Address - Zip Code:38367
Practice Address - Country:US
Practice Address - Phone:731-645-6118
Practice Address - Fax:731-645-8312
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD19117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3036385Medicaid
B62053Medicare UPIN
TN3036385Medicaid