Provider Demographics
NPI:1982719092
Name:CHAKRABARTY, SATYA NARAYAN (MD)
Entity Type:Individual
Prefix:
First Name:SATYA
Middle Name:NARAYAN
Last Name:CHAKRABARTY
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 1:435 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2422
Mailing Address - Country:US
Mailing Address - Phone:931-526-6100
Mailing Address - Fax:931-526-6002
Practice Address - Street 1:435 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2422
Practice Address - Country:US
Practice Address - Phone:931-526-6100
Practice Address - Fax:931-526-6002
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28171174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3821565Medicaid
TN3821565Medicaid