Organization
CHATTANOOGA WOMEN'S SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA W BLAES (OFFICE MANAGER)
(706) 861-5950
Entity
Organization
Contact information
Practice address
2009 OLD LAFAYETTE RD, FORT OGLETHORPE, GA 30742-3510
(706) 861-5950
(706) 858-0475
Mailing address
2009 OLD LAFAYETTE RD, FT OGLETHORPE, GA 30742-3510
(706) 861-5950
(706) 858-0475
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP429
MEDICARE GROUP NUMBER
GA
Enumeration date
09/25/2007
Last updated
08/08/2019
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