Eselgroth, Stephan F

Eselgroth, Stephan F is an individual health care provider with primary practice located at 1013 Executive Dr Ste 102 , Hixson TN 37343-7913. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Eselgroth, Stephan F can be contacted via phone (423) 316-3614.

Contact Information

Primary practice address
1013 Executive Dr Ste 102 Hixson TN 37343-7913
Phone: (423) 316-3614
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 36659 Kentucky
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine 204C00000X MD0000036511 Tennessee
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD0000036511 Tennessee

Profile Details

NPI number 1912902099
LBN Legal business name Eselgroth, Stephan F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated May 26th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912902099 NPPES
Tennessee Other MD0000036511 TN MEDICAL LICENSE NUMBER
Tennessee Other 4051823 TN MEDICAL LICENSE NUMBER
Tennessee Other 36659 TN MEDICAL LICENSE NUMBER
Tennessee Other 250014020 TN MEDICAL LICENSE NUMBER
Tennessee MEDICAID 3879076 TN MEDICAL LICENSE NUMBER

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