Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 58899 | TN |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 58899 | TN |
NPI | 1992064539 |
---|---|
Provider Name | Dr. Carson Tyler Kaeser |
First Address | Chattanooga, TN 37403-3329 |
Second Address | Chattanooga, TN 37403-3329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 17/06/2019 |