Organization
CHATTANOOGA DERMATOLOGY PLLC
Active
Other names
Chattanooga Mohs Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON SUSONG MD (OWNER)
(423) 888-3376
Entity
Organization
Contact information
Practice address
2158 NORTHGATE PARK LN STE 106, CHATTANOOGA, TN 37415-6911
(423) 888-3376
(423) 870-1480
Mailing address
2158 NORTHGATE PARK LN STE 106, CHATTANOOGA, TN 37415-6911
(423) 888-3376
(423) 870-1480
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
09/03/2021
Last updated
07/10/2024
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