Provider Demographics
NPI:1508877341
Name:CHASTAIN, ALLAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:C
Last Name:CHASTAIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2700 WESTSIDE DR NW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3699
Mailing Address - Country:US
Mailing Address - Phone:423-472-1511
Mailing Address - Fax:423-479-9202
Practice Address - Street 1:2700 WESTSIDE DR NW
Practice Address - Street 2:SUITE 103
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3699
Practice Address - Country:US
Practice Address - Phone:423-472-1511
Practice Address - Fax:423-479-9202
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-10-06
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Provider Licenses
StateLicense IDTaxonomies
TNMD009620207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB59305Medicare UPIN
3164317Medicare PIN