Individual
DR. SAMUEL OTTERSON JONES IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Mailing address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
21364
AL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
55695
TN
207RC0001X
Clinical Cardiac Electrophysiology Physician
N0142
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202417603
—
TX
01
—
55695
BOARD OF MEDICAL EXAMINERS
TN
01
—
8CM507
BCBS
TX
01
—
P00898254
RAILROAD MEDICARE
TX
Enumeration date
11/06/2006
Last updated
07/21/2022
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