Individual
DR. JOHN L GWIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
721 GLENWOOD DR, SUITE 553, CHATTANOOGA, TN 37404-1106
(423) 495-2640
(423) 495-2644
Mailing address
721 GLENWOOD DR, SUITE 553, CHATTANOOGA, TN 37404-1106
(423) 495-2640
(423) 495-2644
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD24584
TN
208600000X
Surgery Physician
Primary
24584
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3076991
—
TN
01
—
4088202
BLUE CROSS BLUE SHIELD
TN
Enumeration date
09/07/2005
Last updated
03/05/2010
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