Provider Demographics
NPI:1417922618
Name:ALVAREZ, RICHARD G (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:ALVAREZ
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 1:979 E 3RD ST
Mailing Address - Street 2:SUITE C430
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-624-6584
Mailing Address - Fax:423-624-6588
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE C430
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-624-6584
Practice Address - Fax:423-624-6588
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD009321207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0068840OtherBCBS OF TN PROVIDER NUMBE
TNA99040Medicare UPIN
TN3026531Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER