Organization
OBSTETRICS AND GYNECOLOGICAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL BREEN MD (SECRETARY/TREASURER)
(423) 778-7515
Entity
Organization
Contact information
Practice address
979 E 3RD ST, SUITE C 725, CHATTANOOGA, TN 37403-2136
(423) 778-2580
(423) 778-2060
Mailing address
PO BOX 550, CHATTANOOGA, TN 37401-0550
(423) 778-2580
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3373307
—
TN
Enumeration date
09/12/2005
Last updated
08/03/2010
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