Provider Demographics
NPI:1568971166
Name:BERNARD PARHAM MD PLLC
Entity Type:Organization
Organization Name:BERNARD PARHAM MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PARHAM
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:423-800-8337
Mailing Address - Street 1:3475 BRAINERD RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3542
Mailing Address - Country:US
Mailing Address - Phone:423-800-8337
Mailing Address - Fax:423-760-8257
Practice Address - Street 1:3475 BRAINERD RD BLDG B
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3542
Practice Address - Country:US
Practice Address - Phone:423-800-8337
Practice Address - Fax:423-760-8257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN021556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty