Individual
RYAN BODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 778-5179
(423) 778-2108
Mailing address
975 E. THIRD STREET, BOX 159-PAYER RELATIONS, CHATTANOOGA, TN 37403
(423) 778-5179
(423) 778-2108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DO3756
TN
208M00000X
Hospitalist Physician
Primary
DO3756
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO3756
MEDICAL LICENSE
TN
Enumeration date
04/11/2016
Last updated
07/30/2019
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