Individual
CARLTON MARK VOLLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1608 GUNBARREL RD, SUITE 102, CHATTANOOGA, TN 37421-7197
(423) 296-0382
(423) 296-0383
Mailing address
1608 GUNBARREL RD, SUITE 102, CHATTANOOGA, TN 37421-7197
(423) 296-0382
(423) 296-0383
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D01391
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4134244
BLUE CROSS
TN
Enumeration date
10/14/2005
Last updated
10/24/2011
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