Basic Information
| Provider Information | |||||||||
| NPI: | 1023544871 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCLELLAN | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1949 GUNBARREL RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374217133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234954345 | ||||||||
| FaxNumber: | 4234954934 | ||||||||
| Practice Location | |||||||||
| Address1: | 4700 BATTLEFIELD PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | RINGGOLD | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307365168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7068614990 | ||||||||
| FaxNumber: | 7068619405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | 61985 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | 207QA0505X | 38347 | AL | N | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | 207QA0505X | 86815 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.