Individual
DR. STEPHAN F ESELGROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2333 MCCALLIE AVE, CHATTANOOGA, TN 37404-3258
(423) 698-6061
Mailing address
302 NORTHGATE MALL DR., # 597, HIXSON, TN 37343
(423) 316-3614
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
MD0000036511
TN
208100000X
Physical Medicine & Rehabilitation Physician
36659
KY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD0000036511
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250014020
RR MEDICARE
TN
01
—
36659
KY MEDICAL LICENSE NUMBER
KY
05
—
3879076
—
TN
01
—
4051823
BCBS ID NUMBER
TN
01
—
MD0000036511
TN MEDICAL LICENSE NUMBER
TN
Enumeration date
06/16/2005
Last updated
12/03/2025
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