Provider Demographics
NPI:1871567388
Name:HOLSEY, TANJA A (MD)
Entity type:Individual
Prefix:
First Name:TANJA
Middle Name:A
Last Name:HOLSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:GALEN MEDICAL GROUP
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-1030
Mailing Address - Country:US
Mailing Address - Phone:423-308-0280
Mailing Address - Fax:423-308-0281
Practice Address - Street 1:1651 GUNBARREL RD
Practice Address - Street 2:STE 301 GALEN MEDICAL GROUP
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-899-2580
Practice Address - Fax:423-308-0277
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN25884207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83958Medicare UPIN
TN3083825Medicare ID - Type Unspecified