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Organization
CARESTAR MEDICAL ASSOCIATES
Active
Organization
CARESTAR MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP BANNOR M.D. (OWNER)
(423) 760-8700
Entity
Organization
Contact information
Practice address
6106 SHALLOWFORD RD, SUITE 108, CHATTANOOGA, TN 37421-2239
(423) 760-8700
(423) 760-8703
Mailing address
6106 SHALLOWFORD RD, SUITE 108, CHATTANOOGA, TN 37421-2239
(423) 760-8700
(423) 760-8703
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
05/24/2016
Last updated
07/01/2016
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