Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 58661 | TN |
NPI | 1013337070 |
---|---|
Provider Name | Brett Escarza |
First Address | Indianapolis, IN 46206-2930 |
Second Address | Chattanooga, TN 37403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 04/10/2019 |