Sprouse, Larry Richard

Sprouse, Larry Richard is an individual health care provider with primary practice located at 2501 Citico Ave , Chattanooga TN 37404-1127. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Sprouse, Larry Richard can be contacted via phone (423) 697-2000.

Contact Information

Primary practice address
2501 Citico Ave Chattanooga TN 37404-1127
Phone: (423) 697-2000
Fax: (423) 697-2320
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD35273 Tennessee
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 35273 Tennessee

Profile Details

NPI number 1730173634
LBN Legal business name Sprouse, Larry Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Jul 8th, 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 1730173634 NPPES
Tennessee MEDICAID 1515824
Tennessee MEDICAID 009933539
Tennessee MEDICAID 611990120A

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