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Individual

DR. JOSHUA LIDELLE HARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
6141 SHALLOWFORD RD STE 100, CHATTANOOGA, TN 37421-1663
(423) 498-2000
(423) 498-2001
Mailing address
2550 BUSINESS PARK DR NE, CLEVELAND, TN 37311-6503
(423) 605-8075
(423) 472-0454

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
071791
GA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
071791
GA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
2663
TN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
2663
TN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
71791
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003147609A
GA
01
02045387
AMERIGROUP
GA
01
988220
WELLCARE
GA
01
P01363024
RR MEDICARE
GA
05
Q02347
TN
Enumeration date
05/05/2009
Last updated
02/23/2026
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