Provider Demographics
NPI:1780680348
Name:CHATTANOOGA UROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:CHATTANOOGA UROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CURRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-697-0072
Mailing Address - Street 1:725 GLENWOOD DRIVE
Mailing Address - Street 2:SUITE #780
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404
Mailing Address - Country:US
Mailing Address - Phone:423-697-0072
Mailing Address - Fax:423-697-1798
Practice Address - Street 1:725 GLENWOOD DRIVE
Practice Address - Street 2:SUITE #780
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-697-0072
Practice Address - Fax:423-697-1798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN021342208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3060926Medicare ID - Type Unspecified
TNE86186Medicare UPIN