Individual
DR. NICKIE K SOUFLERIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
113 STRINGER ST, CHATTANOOGA, TN 37405-3254
(423) 266-5427
(423) 266-5428
Mailing address
PO BOX 178, SIGNAL MTN, TN 37377-0178
(423) 266-5427
(423) 266-5428
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD24710
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4068642
BCBS PROVIDER #
TN
01
—
MD24710
MD LICENSE #
TN
Enumeration date
06/04/2006
Last updated
07/08/2007
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