Provider Demographics
NPI:1467862649
Name:DYER, ALICIA DANIELS (MD)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:DANIELS
Last Name:DYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:ALICIA
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1949 GUNBARREL ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-495-4349
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:CHI MEMORIAL PEDIATRIC DIAGNOSTIC ASSOCIATES
Practice Address - Street 2:4700 BATTLEFIELD PARKWAY, SUITE 230
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736
Practice Address - Country:US
Practice Address - Phone:423-698-2229
Practice Address - Fax:423-622-0619
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA078283208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics