Organization
BEYOUTIFUL SKIN AND LASER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE D JENKINS (GM)
(423) 877-3568
Entity
Organization
Contact information
Practice address
4066 HIXSON PIKE, CHATTANOOGA, TN 37415-3110
(423) 877-3568
(423) 877-9332
Mailing address
4066 HIXSON PIKE, CHATTANOOGA, TN 37415-3110
(423) 877-3568
(423) 877-9332
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA0000000981
TN
363LF0000X
Family Nurse Practitioner
Primary
8749977
TN
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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