# CARESTAR MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043667686
- **Authorized official:** PHILLIP BANNOR M.D. (OWNER)
- **Authorized official phone:** (423) 760-8700

## Contact information

- **Practice address:** 6106 SHALLOWFORD RD, SUITE 108, CHATTANOOGA, TN 37421-2239
- **Practice address phone:** (423) 760-8700
- **Practice address fax:** (423) 760-8703
- **Mailing address:** 6106 SHALLOWFORD RD, SUITE 108, CHATTANOOGA, TN 37421-2239
- **Mailing address phone:** (423) 760-8700
- **Mailing address fax:** (423) 760-8703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2016
- **Last updated:** 07/01/2016