Organization
NITEOWL PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD FAULKNER (MANAGER)
(423) 209-4210
Entity
Organization
Contact information
Practice address
7446 SHALLOWFORD RD, STE. 103, CHATTANOOGA, TN 37421-8815
(423) 648-6483
(423) 648-6484
Mailing address
7446 SHALLOWFORD RD, STE. 103, CHATTANOOGA, TN 37421-8815
(423) 648-6483
(423) 648-6484
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
06/01/2011
Last updated
05/15/2024
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