Organization
SCENIC CITY RHEUMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD W BRACKETT MD (OWNER)
(423) 893-6890
Entity
Organization
Contact information
Practice address
6145 SHALLOWFORD RD, STE 102, CHATTANOOGA, TN 37421-7808
(423) 893-6890
(423) 648-1115
Mailing address
6145 SHALLOWFORD RD, STE 102, CHATTANOOGA, TN 37421-7808
(423) 893-6890
(423) 648-1115
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16562
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3731246
—
TN
01
—
4110715
BLUE CROSS BLUE SHIELD
TN
Enumeration date
01/23/2007
Last updated
06/09/2023
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