Provider Demographics
NPI:1275893687
Name:NOONAN, DAVID (MD,)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:NOONAN
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5807 MOUNTAIN PASS DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6227
Mailing Address - Country:US
Mailing Address - Phone:423-344-7773
Mailing Address - Fax:
Practice Address - Street 1:5807 MOUNTAIN PASS DR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6227
Practice Address - Country:US
Practice Address - Phone:423-344-7773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000011959207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology