Basic Information
| Provider Information | |||||||||
| NPI: | 1548319734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EVITT | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1949 GUNBARREL RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374213188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234954345 | ||||||||
| FaxNumber: | 4234954934 | ||||||||
| Practice Location | |||||||||
| Address1: | 6401 MOUNTAIN VIEW RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | OOLTEWAH | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373636683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234955890 | ||||||||
| FaxNumber: | 4234955899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2007 | ||||||||
| LastUpdateDate: | 05/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD0000037563 | TN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 38922401 | 05 | TN | MEDICAID | 3704598 | 05 | TN | MEDICAID | 702029710 | 01 | TN | CARITEN | OTHER | 7569457 | 01 | TN | AETNA | OTHER | 2765890 | 01 | TN | CIGNA | OTHER | 4165912 | 01 | TN | BCBS | OTHER |