Provider Demographics
NPI:1588610125
Name:HUSBAND, BETTY JEAN (MD)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:HUSBAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 CARRIAGE PARC DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7147
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:421 CARRIAGE PARC DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7147
Practice Address - Country:US
Practice Address - Phone:423-718-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD30602207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4083211OtherBCBS OF TN
TNP00224356OtherRAILROAD MEDICARE
TN4083215OtherBCBS OF TENNESSEE
TN3832158Medicaid
TNG82945Medicare UPIN
TN4083211OtherBCBS OF TN