Provider Demographics
NPI:1619461605
Name:OPERATIVE MONITORING OF SOUTHEAST TENNESSEE
Entity Type:Organization
Organization Name:OPERATIVE MONITORING OF SOUTHEAST TENNESSEE
Other - Org Name:OMSET
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-718-1842
Mailing Address - Street 1:200 W. MLK BLVD
Mailing Address - Street 2:SUITE 1000 (10TH FLOOR)
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402
Mailing Address - Country:US
Mailing Address - Phone:423-903-3112
Mailing Address - Fax:
Practice Address - Street 1:200 W. MLK BLVD
Practice Address - Street 2:SUITE 1000 (10TH FLOOR)
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402
Practice Address - Country:US
Practice Address - Phone:423-903-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty