Mr Charles David Dietzen, MD - General Practice in Chattanooga, TN

Mr Charles David Dietzen, MD is a General Practice physician based in Chattanooga, Tennessee. Mr Charles David Dietzen is licensed to practice in Tennessee (license number 009627) and his current practice location is 4355 Highway 58, Suite 101, Chattanooga, Tennessee. He can be reached at his office (for appointments etc.) via phone at (423) 892-4289.

NPI number for Mr Charles David Dietzen is 1417964248 and his current mailing address is 2621 Crestwood Dr, Chattanooga, Tennessee. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417964248.

Contact Information

Mr Charles David Dietzen, MD
4355 Highway 58, Suite 101,
Chattanooga, TN 37416-2939
(423) 892-4289
(423) 892-8301



Physician's Profile

Full NameMr Charles David Dietzen
GenderMale
SpecialityGeneral Practice
Location4355 Highway 58, Chattanooga, Tennessee
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1417964248
  • Provider Enumeration Date: 08/02/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Mr Charles David Dietzen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417964248NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208D00000XGeneral Practice 009627 (Tennessee)Primary
208D00000XGeneral Practice 051638 (Georgia)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Charles David Dietzen is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Charles David Dietzen, MD
2621 Crestwood Dr,
Chattanooga, TN 37415-6321

Ph: (423) 266-3500
Mr Charles David Dietzen, MD
4355 Highway 58, Suite 101,
Chattanooga, TN 37416-2939

Ph: (423) 892-4289

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General Practice Doctors in Chattanooga, TN

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Practice Location: 3812 Tennessee Ave, Chattanooga, TN 37409
Phone: 423-821-1177    Fax: 423-821-1188

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