Provider Demographics
NPI:1760603666
Name:CHATTANOOGA BONE & JOINT SURGEONS, PC
Entity Type:Organization
Organization Name:CHATTANOOGA BONE & JOINT SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:REDISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-893-9020
Mailing Address - Street 1:1809 GUNBARREL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7185
Mailing Address - Country:US
Mailing Address - Phone:423-893-9020
Mailing Address - Fax:423-893-9040
Practice Address - Street 1:1809 GUNBARREL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7185
Practice Address - Country:US
Practice Address - Phone:423-893-9020
Practice Address - Fax:423-893-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherTAX ID NUMBER
TN=========OtherTAX ID NUMBER
TN3704075Medicare PIN