Individual
GRANT W HUNTZINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1604 GUNBARREL RD, CHATTANOOGA, TN 37421-3125
(423) 893-7226
(423) 893-7398
Mailing address
1604 GUNBARREL RD, CHATTANOOGA, TN 37421-3125
(423) 648-2395
(423) 648-7542
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
022420
GA
2085R0202X
Diagnostic Radiology Physician
Primary
MD11568
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000248476
—
GA
01
—
151364
BCBS OF GA
GA
05
—
3805918
—
TN
01
—
4073000
BCBS OF TN
TN
01
—
44770
BCBS OF TN
TN
01
—
511425
BCBS OF GA
GA
Enumeration date
07/21/2006
Last updated
02/22/2018
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