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MR. CHARLES DAVID DIETZEN MD
NPI 1417964248
General Practice in Chattanooga, TN

Active since August 02, 2006
4355 HIGHWAY 58, SUITE 101, CHATTANOOGA, TN 37416(423) 892-4289(423) 892-8301 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Charles David Dietzen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CHARLES DAVID DIETZEN MD (NPI 1417964248) is an individual general practice provider in Chattanooga, Tennessee, licensed in Tennessee (009627) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1417964248
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameMR. CHARLES DAVID DIETZENCredential: MD
Location Address4355 HIGHWAY 58, SUITE 101Chattanooga, TN 37416-2939
Mailing Address2621 Crestwood DrChattanooga, TN 37415-6321 · (423) 266-3500
Phone(423) 892-4289
Fax(423) 892-8301
Sole ProprietorNo
Enumeration DateAugust 2, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1417964248 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in TN · 009627✔ Licensed in GA · 051638
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
4355 HIGHWAY 58, Chattanooga, TN 37416
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Other Identifiers 1

Medicare UPINB63029

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH A. MOTTO, MD
Otolaryngology
4355 HIGHWAY 58, SUITE 107A
CHATTANOOGA, TN 37416
Hamilton County (423) 842-5260
JOSEPH MOTTO M.D.
Otolaryngology
4355 HIGHWAY 58, SUITE 107A
CHATTANOOGA, TN 37416
Hamilton County (423) 443-3524

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Dietzen's NPI number?

The NPI number for Charles Dietzen is 1417964248. It was assigned to this individual provider in the NPPES registry on August 2, 2006.

Where is Charles Dietzen located?

Charles Dietzen practices at 4355 Highway 58 Suite 101, Chattanooga, TN 37416. The listed phone number is (423) 892-4289.

What is Charles Dietzen's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Charles Dietzen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.