# OB-GYN CENTRE OF EXCELLENCE PC

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

## Provider details

- **NPI number:** 1699796169
- **Authorized official:** MRS. MISTY A HICKMAN (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (423) 629-9743

## Contact information

- **Practice address:** 2341 MCCALLIE AVE STE 302, PARKRIDGE PLAZA III, CHATTANOOGA, TN 37404-3237
- **Practice address phone:** (423) 629-9743
- **Practice address fax:** (423) 629-9744
- **Mailing address:** 2341 MCCALLIE AVE, SUITE 302, PARKRIDGE PLAZA III, CHATTANOOGA, TN 37404-3237
- **Mailing address phone:** (423) 629-9743
- **Mailing address fax:** (423) 629-9744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 09/10/2010