Individual
EUGENE D. EDDLEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2253 CHAMBLISS AVE., STE. 401, CLEVELAND, TN 37311
(423) 267-0466
(423) 778-5177
Mailing address
979 E 3RD STREET, STE. 300, CHATTANOOGA, TN 37403-2187
(423) 267-0466
(423) 778-5177
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G68376
CA
2086S0129X
Vascular Surgery Physician
G68376
CA
2086S0129X
Vascular Surgery Physician
Primary
MD67391
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G683761
—
CA
01
—
94-3365249
PRIVATE PAYERS
CA
01
—
G68376
BLUE CROSS/SHIELD, ETC.
CA
05
—
Q090231
—
TN
Enumeration date
07/06/2006
Last updated
10/25/2024
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