Provider Demographics
NPI:1184732315
Name:CHATTANOOGA COMPREHENSIVE CARE PLLC
Entity type:Organization
Organization Name:CHATTANOOGA COMPREHENSIVE CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUNSON-JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-648-6496
Mailing Address - Street 1:7446 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-8815
Mailing Address - Country:US
Mailing Address - Phone:423-648-6496
Mailing Address - Fax:423-648-6484
Practice Address - Street 1:7446 SHALLOWFORD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8815
Practice Address - Country:US
Practice Address - Phone:423-648-6496
Practice Address - Fax:423-648-6484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty