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Individual

BEN EDGAR COTTRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 BLACK CREEK DR, CHATTANOOGA, TN 37419-2190
(931) 588-6356
Mailing address
705 BLACK CREEK DR, CHATTANOOGA, TN 37419-2190
(931) 588-6356

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35175
TN
207Q00000X
Family Medicine Physician
35175
TN
208M00000X
Hospitalist Physician
35175
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3862460
TN
05
3862466
TN
01
4144771
BLUE CROSS
TN
01
TN0109
AMERICHOICE
TN
Enumeration date
05/25/2006
Last updated
07/06/2016
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