Individual
MR. EDWARD BRIAN HALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 602-8400
(423) 602-8401
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 602-8400
(423) 602-8401
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10767
TN
367500000X
Certified Registered Nurse Anesthetist
RN163737
GA
367500000X
Certified Registered Nurse Anesthetist
RN99856
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3631302
—
TN
01
—
4033046
BCBS
TN
Enumeration date
02/27/2006
Last updated
04/15/2016
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