Provider Demographics
NPI:1538187224
Name:ELIAS, CAROLINE K (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:K
Last Name:ELIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3898 HIXSON PIKE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-3562
Mailing Address - Country:US
Mailing Address - Phone:423-624-1500
Mailing Address - Fax:423-622-1226
Practice Address - Street 1:3898 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-3562
Practice Address - Country:US
Practice Address - Phone:423-624-1500
Practice Address - Fax:423-622-1226
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25568207W00000X
TNMD25568207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3083266Medicaid
180029156OtherRAILROAD MEDICARE
TN3083266Medicare PIN
TN3083266Medicaid
TN3083266Medicare PIN