Provider Demographics
NPI:1548532773
Name:STITHEM, DOUG (DC)
Entity type:Individual
Prefix:DR
First Name:DOUG
Middle Name:
Last Name:STITHEM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 GUNBARREL RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7174
Mailing Address - Country:US
Mailing Address - Phone:423-475-5294
Mailing Address - Fax:423-475-6533
Practice Address - Street 1:1510 GUNBARREL RD
Practice Address - Street 2:SUITE 600
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7174
Practice Address - Country:US
Practice Address - Phone:423-475-5294
Practice Address - Fax:423-475-6533
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2566111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor