Provider Demographics
NPI:1427169432
Name:STEVEN K. AUSTIN, MD, PC
Entity type:Organization
Organization Name:STEVEN K. AUSTIN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-648-0613
Mailing Address - Street 1:6031 SHALLOWFORD ROAD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1688
Mailing Address - Country:US
Mailing Address - Phone:423-495-9581
Mailing Address - Fax:423-495-9583
Practice Address - Street 1:6031 SHALLOWFORD ROAD
Practice Address - Street 2:SUITE 117
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1688
Practice Address - Country:US
Practice Address - Phone:423-495-9581
Practice Address - Fax:423-495-9583
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEVEN K. AUSTIN, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000022043207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3076909Medicaid
GA000741408BMedicaid
TN3073909Medicaid
TN3073909Medicare PIN
TN3076909Medicaid
TN3073909Medicaid
TNF29012Medicare UPIN
TN3076909Medicare PIN