Doctor Name: | DR. LARRY RICHARD SPROUSE |
NPI Number: | 1730173634 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD35273 |
Business Practice Address: | 2108 E 3rd St Suite 200 Chattanooga, TN - 374042600 |
Business Phone Number: | 4232670466 |
Business Fax Number: | 4234932370 |
Mailing Address: | 979 E 3rd St, Ste 300 CHATTANOOGA |
State: | TN |
Postal Code: | 374032136 |
Phone Number: | 4232670466 |
Fax Number: | 4237570770 |
NPI Enumeration Date: | 09/07/2005 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD35273 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |