Individual
DR. LARRY RICHARD SPROUSE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2320
Mailing address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2320
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD35273
TN
2086S0129X
Vascular Surgery Physician
Primary
35273
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009933539
—
AL
05
—
1515824
—
TN
05
—
611990120A
—
GA
Enumeration date
09/07/2005
Last updated
07/08/2020
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