Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 38347 | AL |
N | 207QA0505X | Family Doctor - Adult Medicine | 61985 | TN |
Y | 207QA0505X | Family Doctor - Adult Medicine | 86815 | GA |
NPI | 1023544871 |
---|---|
Provider Name | Katherine S Mcclellan |
First Address | Chattanooga, TN 37421-7133 |
Second Address | Ringgold, GA 30736-5168 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 10/11/2020 |