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Individual

DR. CHAD T. COUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
350 BLOUNTVILLE HWY, SUITE 105, BRISTOL, TN 37620-0213
(423) 844-6600
(423) 968-1255
Mailing address
350 BLOUNTVILLE HWY, SUITE 105, BRISTOL, TN 37620-0213
(423) 844-6600
(423) 968-1255

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
034328
TN
208800000X
Urology Physician
Primary
34328
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007503849
VA
01
0213340004
DMERC
01
3150974
BLUECROSS BLUESHIELD
TN
01
340017986
RR MEDICARE
01
381841
ANTHEM
VA
05
3854657
TN
01
62086999805
JOHN DEERE
Enumeration date
05/19/2006
Last updated
06/16/2010
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