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Contact Information

SOUTHEASTERN SPINE, PLLC
281 NORTH LYERLY STREET
SUITE 300
CHATTANOOGA, TN37404-2728
 Phone: 423-693-2175
 Fax: 888-959-1015
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
 

Orthopaedic Surgery of the Spine

207XS0117X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for SOUTHEASTERN SPINE PLLC · (Female)

NPI Number 1518215219
Status Active
Credentials
Entity Individual
Enumeration date 08/28/2012
Last updated 04/04/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • TN Medicaid Q068733
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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