Provider Demographics
NPI:1043418742
Name:SENTEF MEDICAL CENTER
Entity Type:Organization
Organization Name:SENTEF MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SENTEF
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:423-553-9394
Mailing Address - Street 1:6740 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2423
Mailing Address - Country:US
Mailing Address - Phone:423-553-9394
Mailing Address - Fax:423-553-9398
Practice Address - Street 1:6740 LEE HWY
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2423
Practice Address - Country:US
Practice Address - Phone:423-553-9394
Practice Address - Fax:423-553-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN000121363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3855491Medicare ID - Type Unspecified