Basic Information
| Provider Information | |||||||||
| NPI: | 1275055394 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLATZER | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | VANLANDINGHAM | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VANLANDINGHAM | ||||||||
| OtherFirstName: | ASHLEY | ||||||||
| OtherMiddleName: | VIRGINIA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1949 GUNBARREL RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374217133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234954345 | ||||||||
| FaxNumber: | 4234954934 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 WALMART DR | ||||||||
| Address2: | |||||||||
| City: | SODDY DAISY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373795022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233326155 | ||||||||
| FaxNumber: | 4233325293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2017 | ||||||||
| LastUpdateDate: | 09/15/2021 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 09/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 3648 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.