Individual
PAUL LARRY DASSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 E 3RD ST, CHATTANOOGA, TN 37403-2241
(423) 778-9300
(423) 778-9301
Mailing address
PO BOX 11023, CHATTANOOGA, TN 37401-2023
(423) 778-9300
(423) 778-9301
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34878
KY
207QA0000X
Adolescent Medicine (Family Medicine) Physician
34878
KY
207QA0505X
Adult Medicine Physician
34878
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
34878
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64348782
—
KY
Enumeration date
06/15/2006
Last updated
06/27/2012
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