Organization
THE PLASTIC SURGERY GROUP,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTYE J CHASTAIN (SUPERVISOR)
(423) 763-4543
Entity
Organization
Contact information
Practice address
1949 GUNBARREL RD STE 303, CHATTANOOGA, TN 37421-3188
(423) 756-7134
(423) 763-4571
Mailing address
901 RIVERFRONT PARKWAY, STE 100, CHATTANOOGA, TN 37402-2102
(423) 756-7134
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
55433
TN
2086S0105X
Surgery of the Hand (Surgery) Physician
26787
TN
2086S0105X
Surgery of the Hand (Surgery) Physician
28796
TN
2086S0105X
Surgery of the Hand (Surgery) Physician
36502
TN
2086S0122X
Plastic and Reconstructive Surgery Physician
28796
TN
2086S0122X
Plastic and Reconstructive Surgery Physician
36502
TN
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
38782
TN
2086S0122X
Plastic and Reconstructive Surgery Physician
55433
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006636
BLUE CROSS BLUE SHIELD
TN
01
—
CL7313
RAILROAD MEDICARE
TN
Enumeration date
03/20/2018
Last updated
01/28/2019
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