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Individual

BRETT DAVID MCDONOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2020 GUNBARREL ROAD, SUITE 100E, CHATTANOOGA, TN 34742-2663
(423) 899-9125
(423) 899-9030
Mailing address
PO BOX 21821, CHATTANOOGA, TN 37424-0821
(423) 899-9125
(423) 899-9030

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1825
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10025073
PHP
05
3941806
TN
01
4035668
BCBS
Enumeration date
09/28/2006
Last updated
04/12/2012
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