1861446676 NPI number — DR. CHAD T. COUCH M.D.

Table of content: DR. ANANT B BHOGAONKER MD (NPI 1457333718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861446676 NPI number — DR. CHAD T. COUCH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COUCH
Provider First Name:
CHAD
Provider Middle Name:
T.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861446676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 BLOUNTVILLE HWY
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
BRISTOL
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37620-0213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-844-6600
Provider Business Mailing Address Fax Number:
423-968-1255

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 BLOUNTVILLE HWY
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
BRISTOL
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37620-0213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-844-6600
Provider Business Practice Location Address Fax Number:
423-968-1255
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  034328 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: 34328 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3150974 . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 381841 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0213340004 . This is a "DMERC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 340017986 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3854657 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 007503849 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 62086999805 . This is a "JOHN DEERE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com