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Individual

DR. LOYD WILLIAM WITHERSPOON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1510 GUNBARREL RD, SUITE 300, CHATTANOOGA, TN 37421-7174
(423) 499-6488
(423) 855-4100
Mailing address
5000 W ESPLANADE AVE, PMB 235, METAIRIE, LA 70006-2551
(504) 779-8120
(504) 779-9741

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM380
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000776058A
GA
05
3353790
TN
01
4047259
BLUE CROSS
TN
01
412064222001
TRICARE
TN
01
480035339
RAILROAD MEDICARE
TN
01
DA2202
RAILROAD MEDICARE GROUP
TN
01
TN0101
UHC OF RIVER VALLEY
TN
Enumeration date
12/20/2006
Last updated
07/25/2012
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