Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 66519 | MT |
NPI | 1215374251 |
---|---|
Provider Name | Hugh Toland Stoddard III |
First Address | Hixson, TN 37343-5470 |
Second Address | Chattanooga, TN 37421-3289 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2013 |
Last Update Date | 26/08/2021 |