Provider Demographics
NPI:1780624882
Name:WHARTON, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:WHARTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:707 MOUNT OLIVE RD
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30750-2926
Mailing Address - Country:US
Mailing Address - Phone:706-820-0286
Mailing Address - Fax:727-507-3618
Practice Address - Street 1:975 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2103
Practice Address - Country:US
Practice Address - Phone:423-778-7296
Practice Address - Fax:423-778-8068
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
TN17079207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A98624Medicare UPIN