Provider Demographics
NPI:1912176082
Name:HAMILTON COUNTY NEUROLOGY PC
Entity Type:Organization
Organization Name:HAMILTON COUNTY NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-778-4278
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-0128
Mailing Address - Country:US
Mailing Address - Phone:423-778-4278
Mailing Address - Fax:
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE 1210
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-778-4278
Practice Address - Fax:423-778-4262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN310422084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG60764Medicare UPIN
TN3832237Medicare PIN