Provider Demographics
NPI:1588833925
Name:DELLINGER, CARYL ANN (MD)
Entity Type:Individual
Prefix:
First Name:CARYL
Middle Name:ANN
Last Name:DELLINGER
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 1:979 EAST THIRD STREET
Mailing Address - Street 2:ERLANGER-SOUTHEAST REGIONAL STROCK CENTER
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403
Mailing Address - Country:US
Mailing Address - Phone:423-778-9001
Mailing Address - Fax:423-778-4692
Practice Address - Street 1:979 EAST THIRD STREET
Practice Address - Street 2:ERLANGER-SOUTHEAST REGIONAL STROCK CENTER
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:715-387-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC393922084N0400X
WI547332084N0400X
MO20090238812084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC393924Medicaid
SC393924Medicaid