Larson, Tim Vernon

Larson, Tim Vernon is an individual health care provider with primary practice located at 5600 Brainerd Rd Ste A4 , Chattanooga TN 37411-5336. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Larson, Tim Vernon can be contacted via phone (423) 266-4588.

Contact Information

Primary practice address
5600 Brainerd Rd Ste A4 Chattanooga TN 37411-5336
Phone: (423) 266-4588
Fax: (865) 342-0103
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD29692 Tennessee

Profile Details

NPI number 1962487157
LBN Legal business name Larson, Tim Vernon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2005
Last updated Sep 30th, 2020 - about 4 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 1962487157 NPPES
Other 4102995 BLUE CROSS BLUE SHIELD
MEDICAID 3820357 BLUE CROSS BLUE SHIELD

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