Provider Demographics
NPI:1265438303
Name:EYE SURGERY CENTER OF CHATTANOOGA, LLC
Entity type:Organization
Organization Name:EYE SURGERY CENTER OF CHATTANOOGA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIERLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-643-3937
Mailing Address - Street 1:7268 JARNIGAN RD
Mailing Address - Street 2:STE 104
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3096
Mailing Address - Country:US
Mailing Address - Phone:423-643-3937
Mailing Address - Fax:423-643-3938
Practice Address - Street 1:7268 JARNIGAN RD
Practice Address - Street 2:STE 104
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3096
Practice Address - Country:US
Practice Address - Phone:423-643-3937
Practice Address - Fax:423-643-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000162261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3288846Medicaid
GA037112342AMedicaid
ALASC0070CMedicaid
TN3288846Medicare PIN