Provider Demographics
NPI:1770751240
Name:VEIN THERAPIES OF CHATTANOOGA, PLLC
Entity type:Organization
Organization Name:VEIN THERAPIES OF CHATTANOOGA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GRIFFIN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-648-4181
Mailing Address - Street 1:6031 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1688
Mailing Address - Country:US
Mailing Address - Phone:423-648-4181
Mailing Address - Fax:423-648-4183
Practice Address - Street 1:6031 SHALLOWFORD RD
Practice Address - Street 2:SUITE 113
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1688
Practice Address - Country:US
Practice Address - Phone:423-648-4181
Practice Address - Fax:423-648-4183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14484208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA96841Medicare UPIN