Provider Demographics
NPI:1306855655
Name:CLAXTON, RITA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:RENEE
Last Name:CLAXTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:979 E 3RD ST
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-266-1490
Mailing Address - Fax:423-648-4570
Practice Address - Street 1:975 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2103
Practice Address - Country:US
Practice Address - Phone:423-266-1490
Practice Address - Fax:423-648-4570
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN28468207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3805844Medicaid
TN3805844Medicaid
G49111Medicare UPIN