Organization
PHILIP BANNOR MD PLLC
Active
Other names
New Covenant Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP A BANNOR MD (PRESIDENT)
(423) 553-6636
Entity
Organization
Contact information
Practice address
6106 SHALLOWFORD RD, # 108, CHATTANOOGA, TN 37421-1615
(423) 553-6636
(423) 553-6667
Mailing address
6106 SHALLOWFORD RD, # 108, CHATTANOOGA, TN 37421-1615
(423) 553-6636
(423) 553-6667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3728871
—
TN
Enumeration date
03/16/2007
Last updated
02/16/2011
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