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Individual

RICHARD A ZACHARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
975 E. THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN072321
GA
163W00000X
Registered Nurse
RN44615
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN08952
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000573658A
GA
05
009710030
AL
05
1513892
TN
01
3040273
BLUE CROSS BLUE SHIELD TN
TN
01
430030834
RAILROAD MEDICARE
TN
05
8052517
NC
01
N362329
WELLCARE (GA MEDICAID)
GA
Enumeration date
12/11/2006
Last updated
02/16/2010
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