Individual
DAVID F ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2103
(423) 778-7806
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-9483
(423) 899-0928
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO00749
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000380047C
—
GA
05
—
009602430
—
AL
01
—
050047705
MEDICARE RAILROAD
TN
01
—
3031773
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
05
—
3302285
—
TN
05
—
890550M
—
NC
Enumeration date
08/15/2006
Last updated
06/02/2008
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