Provider Demographics
NPI:1730259615
Name:TRI STATE PSYCHIATRIC SERVICES PC
Entity type:Organization
Organization Name:TRI STATE PSYCHIATRIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF CORPORATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:APPAREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-505-4693
Mailing Address - Street 1:6918 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-499-6165
Mailing Address - Fax:423-499-0693
Practice Address - Street 1:6918 SHALLOWFORD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-499-6165
Practice Address - Fax:423-499-0693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0222122084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty