Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD009321 | TN |
NPI | 1417922618 |
---|---|
Provider Name | Richard G Alvarez |
First Address | Chattanooga, TN 37403-2136 |
Second Address | Chattanooga, TN 37403-2136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 26/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0068840 | BCBS OF TN PROVIDER NUMBE (01) | TN |
A99040 | (02) | TN |